HomeMy WebLinkAbout020-1163-20-000
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Parcel 020-1163-20-000 05/14/2012 04:07 PM
PAGE 1 OF 1
Alt. Parcel M 12.29.20.940.941 020 - TOWN OF HUDSON
Current 1XI ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
JASON & JENNIFER COLEMAN O - COLLMAN, JASON & JENNIFER
1072 EDGEWOOD CIR
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): = Primary
Type Dist # Description 1072 EDGEWOOD CIR
SC 2611 SCH DIST OF HUDSON
SP 1700 WITC
Legal Description: Acres: 1.019 Plat: 05-015-EDGEWOOD ESTATES
SEC 12 T29N R20W EDGEWOOD ESTATES LOTS Block/Condo Bldg: LOT 10
10&11
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
12-29N-20W
Notes: Parcel History:
Date Doc # Vol/Page Type
03/18/2005 789947 2767/306 WD
07/23/1997 749/300
07/23/1997 726/557
07/23/1997 726/555
2012 SUMMARY Bill M Fair Market Value: Assessed with:
0
Valuations: Last Changed: 08/16/2010
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.019 43,400 144,600 188,000 NO
Totals for 2012:
General Property 1.019 43,400 144,600 188,000
Woodland 0.000 0 0
Totals for 2011:
General Property 1.019 43,400 144,600 188,000
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch M 311
Specials:
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Parcel 020-1163-20-000 12/13/2004 05:00 PM
PAGE 1 OF 1
Alt. Parcel 12.29.20.940.941 020 - TOWN OF HUDSON
Current XX ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): * = Current Owner
* EVANS, RONALD E & LORNA ANN
RONALD E & LORNA ANN EVANS
1072 EDGEWOOD CIR
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 1072 EDGEWOOD CIR
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 1.019 Plat: 1929-EDGEWOOD ESTATES
SEC 12 T29N R20W EDGEWOOD ESTATES LOTS Block/Condo Bldg: LOT 10
10&11
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
12-29N-20W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 749/300
07/23/1997 726/557
07/23/1997 726/555
2004 SUMMARY Bill Fair Market Value: Assessed with:
49022 190,000
Valuations: Last Changed: 10/26/2001
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.019 32,300 114,700 147,000 NO
Totals for 2004:
General Property 1.019 32,300 114,700 147,000
Woodland 0.000 0 0
Totals for 2003:
General Property 1.019 32,300 114,700 147,000
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch M 311
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
Form- S T C - 104
AS BUILT SANITARY SYSTEM REPORT
f
` OWNER la 7TOWNSHIP SEC. /,_7- T 9~ N-R W W
ADDRESS 3~ ST. CROIX COUNTY, WISCONSIN
SUBDIVISION ~9 LOT 16F, Ittl LOT SIZE
PLAN VIEW
Distances and dimensions to meet requirements of ILHR 83
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
Se147,C
k 11
INDICATE NORTH ARROW
BENCHMARK: Describe the vertical reference point used a,5 /r
Elevation of vertical reference point: Proposed slope at site:
SEPTIC TANK: Manufacturer: Liquid Capacity:
Number of rings used: 6F Tank manhole cover elevation: -~U
Tank Inlet Elevation: 1; XJ Tank Outlet Elevation:
Number of feet from nearest Road:
Front,O Side G Rear, O feet
.From nearest property line Front 10 Side 10 Rear, 0 ~j Q feet
Number of feet from: well "~Za, building: il,',
(Include this information of the above plot plan)( 2 reference dimensions to septic tank)
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, Ft.
Number of feet from well:
Number of feet from building:
(Include distances on plot plan).
SOIL ABSORPTION SYSTEM
Bed: Trench:
Width: Length:f ~e Number of Lines: _ Area Built:
Fill depth to top of pipe: o? "
Number of feet from nearest property line: Front, O Side, O Rear,0 Ft . ~S
Number of feet from well:
Number of feet from building:9
(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: n~~/H✓~~-
License Number :
3/84:mj
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS
DIVISION
i LABOR & HUMAN RELATIONS - PRIVATE SEWAGE SYSTEMS
P.O. BOX 7969 ,t BUREAU OF PLUMBING
MADISON, WI 53707 0 CONVENTIONAL DALTER NATIVE State Plan l.D. Number.
IIf ass,gneci)
❑ Holding Tank D In-Ground Pressure ❑ Mound
NAME OF PERMIT HOLDER: DDRESS OF PERMIT HOLDER. INSPECTION DATE
B 9 H Development A 836 St. Croix St. N., Hu.d6on, W1
BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.' CST HEP PT. ELEV
SE NE, Section 12, T29N-R20W, Town of Hud6on, Lo;W 10-11, EdgewOUd E6 .
N:unr of Plumber: IMP/MPRSW No.. County S.mwy Perm,, Number-
GIi.e iam Seh.u.makeA 6382 St. Cnvix 83812
SEPTIC TANK/HOLDING TANK: if i
MANUFACTURER LIQUID CAPACITY TANK INLET ELEV. TANK OUTLET ELEV JWARNING LABEL LOCKING COVER
y PROVIDED PROVIDED
YES ONO OYES ONO
BEDDING VENT DIA. VE(.;NT MATL. 11116H WATER NUMBER OF ROAD. PROPERTY WELL IBUILDtN_; (VENT TO FRESH
)r ALARM LINE Alit ET FEET FR YES ONO / DYES ONO NEARESTOM VG C~ r 7
DOSING CHAMBER:
MANUFACTURER BEDDING LIpUIO CAPACITY JPUMP MODEL PUMP. SIPHON MA NUF ACTUHEH WARNING LABEL LOCKING COVER
PROVIDED. PROVIDED
OYES ON DYES ONO DYES ONO
GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. NUMBER OF PH( ['Fit IV 11111 IL BUILDING IVE NT TO FFit SH
(DIFFERENCE BETWEEN FEET FROM LINE AIR INI EI
PUMP ON AND OFF) OYES ONO NEAREST 311.
SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE EN(ITH 1111AMf TE I+ IMA11IIIA[AND4IAHKINI,
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 LE TH NO OF DISTR P E SPACING COVER INSIDE OIA -PITS DEPT1O
BED/TRENCH THENegFS t"""~"' L IT PIII
DIMENSIONS p` GRAVEL DEPTH FILL DEPiUIS1H PIUISTR PIPE DISTR. PF MATERIAL rFNEAREST------ii.- UMBER OF PHOVEHTV WELL LUING VENT iO FHf St
HF LOW PIPES ABOVE CVI I I V INI I I ELEV ENU LINE AIH INLE T
EET FROM ✓ /i
9119 5 % I~~
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 ONO _
SOIL COVER TEXTURE PEHMANI NI MAHKI 175 1111111 HVAIH N WI I I S
OYES ONO _ DYES
ONO
DEPTH OVER THE N(:H BED DEPTH OVER TRENCH BEU OEVTH (7F TOPSOIL [ODI)i I) "'0") MDLCHf U
CENT Eft EDGES
OYES ONO OYES ONO OYES DNO
PRESSURIZED DISTRIBUTION SYSTEM: _
BED/TRENCH WIDTH LENGTH TRENCHES LATERAL SPACIN(, 11HAVEL D' PIT' HI LOW PIP[ F IL L DEPTH ABOVE COVE H
DIMENSIONS
MANIFOLD PUMP MANIFOLD) DISTR. PIPE MANROLOMATEHIAL NO UISTR I)ISttl PIPI 1)ISIIfIH1)IIONI'IPt MAIf HIAI &MAHKINI.
ELEV. ELEV. CIA ELEV. PIPES DIA.
ELEVATION AND
DISTRIBUTION
INFORMATION HOLE SIZE HOLE SPACING DRILLEOCOHRICIIV COVFH MATE HIAL VIRIWAI 111 T COHHf SPONDS IOAPPHOVIO
PL ANS
DYES ONO OYES ONO
COMMENTS: PERMANENT MARKERS: 7=TI ON WE L LS: NUMBER OF PROPERTY WELL BUILDING
FEET FROM LINE.
OYES ONO DYES 1:1 NO NEAREST
Sketch System on Retain in county file for audit.
Reverse Side.
SIC AT TITLE
DILHR SBD 6710 (R. 01/83) iq _ I
SANITARY PERMIT APPLICATION CO UN Y
7DILHF~ In accord with ILHR 83.05, Wis. Adm. Code
~ STATE SANITARY PERMIT
-Attach cqmplete plans (to the county copy only) for the system, on paper not less than STATE PLAN I.D. NUMBER
81(1 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
Srf- % A/E'/4, S T 2Q , N, R aD E (or)~p .12 PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME
3 s~ro-' ids 1✓,' to cad a
CITY TATE ZIP CODE PHONE NUMBER CITY NEAR T ROAD, LAKE OR LANDMARK
Om VILLAGE
II. TYPE OF BUILDING OR USE SERVED:
Number of Bedrooms if 1 or 2 Family 7 OR ❑ Public (Specify):
III. PURPOSE OF APPLICATION: (Check only one in ##1. Check 2,3 or 4, if applicable)
1. a. ® New b. E1 Replacement c. El Replacement of d. ❑ Reconnection of e. El Repair of an
System System Septic Tank Only an Existing System Existing System
2. ❑ A Sanitary Permit was previously issued. Permit Date Issued
3. El 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. El Alternative c. El Experimental
2. a. ❑ System- b. 1:1 Holding c. 11 Pit Privy d. 1:1 Vault Privy e. El Mound f. 1:1 IGP
In-Fill Tank
V. ABSORPTION SYSTEM INFORMATION: (Check one)
1. a. seepage Bed b. ❑ See a e 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):
3 6j l Feet Private ❑ Joint ❑ Public
VI. TANK CAPACITY Site
INFORMATION in allons Total of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper.
New xisting Gallons Tanks Concrete structed glass App.
Tanks Tanks
Septic Tank or Holding Tank lam 6 -0 1 El 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) MP/ PRSW No.: Business Phone Number:
i `/(,'a. n-► /tee ~3~ ~ 3l a ~
Plumber's Address (Street, City, State, Zip Code): Name of Designer:
VIII. SOIL TEST INFORMATION
Certified Soil Tester (CST) Name CST
L 0 3~ ~
CST's ADDRESS (Street, City, State, Zip Code) Phone Number:
'YO -e, / 3
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sani ry Permit Fee harge Groundwater Fee Date Issuing Agent Signature (No Stamps)
r
Approved ❑ Owner Given Initial _ 144Fv
Adverse Determination OJ &2:Z:V(
X. COMMENTS/REASONS FOR DIS PPROVAL:
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; y
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 ytur 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;
Ili. 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'/s 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 negmatior: and public debate. The groundwater bill Groungwate. -
included the creation of surcharges (fees) for a number of regulated practices which Wiscor#Sin`s y
can effect groundwater The surcharge took effect on July 1, 1984. All of the water tha3 A
buried treasure
is used in your building is returned to the groundwate°- through your soil absorption
system or.the disposal site used by your holding tank pumper.
L-
Ttie monies collected through these surcharges are credited to the groundwater 1-Mel adminis tared by the Department of Natural Resources. These funds are used for monitoring
grourso- e>r
water, groundwater contamination investigations and establishment of standards. Gro.undwa€~-:
i"s worth protecting.
sD-6398 (RM/36)
APPLICATION FOR SANITARY PERMIT
STC - 100
• i
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
douse"), then a second form should be retained and completed when the property is
sold and submitted to this office with the appropriate deed recording..
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
()wner of Property i3. 1K . Drsva 1Qpmant Saks.
Lucut Lou of Property lly NW 4, Section 7 , T 29 N - R 19 W
Township Hudson
Mail I inb Address Rt. 2 Edgewood Estates - -
Hudson, Wisconsin
Subdivision Name Edgewood Estates
Lot Number 10, & 11
Previous Owner of Property Anita Marty
'T'otal Size of Parcel Acre Plus
Dale Parcel was Created April 1984
Are all corners and lot lines identifiable? x Yes No
is this property being developed for resale (spec house) ? x Yes No
Volume 685 and Page Number 445'- 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
1 (we) ceAti6y that aU 6ta.tement6 on .th.ia 6oAm ane t,eue to the beat o6 my (uun)
knuwtedge; that 1 (we) am (aae) the owneA(a) o6 the paopeA.ty ducAi.bed in .th,i
016uiunati,un 6onm, by viAtue o6 a wwL arty deed tecokded in the 066ice o6 t:(e
County Regi4teA o6 Deeds ae Document No. 392420 a ; and that I (we)
pne,6e.►►.tXy own .the. ptopoaed bite 6o4 the sewage d poea`f_bya.tem (VA 1 (we) have
obtained an eademen.t, to Aun with the above dese4ibed p&opeA.ty, bon the
eou6tnucti.on o6 aaid 6y.6tem, and the same has been duty %eeonded in the O66-ice
u6 the County Regi.6teA o6 Dena, ab Document No. 392420
Iq
SIGNATURE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE)
DA'T'E SIGNED DATE SIGNED
i
N
v
S T C T 10
v
SEPTIC TANK MAINTENA CE AGREE:MEN'1 0
St. Croix C194nry
v
v
OWNER/BUYER 15• & H. Development Ins.
ROUTE/BOX NUMBER Rt. 2 Edgewoo E$ta.tes -Fire Number
♦ I
CITY/STATE Hudson, Wisconsin 211' ,4016
PROPERTY LOCATION: S . NW 14, Sect ion_.___7..__..' T-29 N I R__19._.~W
Town of Hudson , St:. Croix Cuuuty,
Subdivision Edgewood Estates Lot number I
Improper use'and maintenance of your septic= system could result in
Its premature failure to handle wastes. 11 rup,er maintenance con-
sists of pumping out the septic tank every ti►ree years or sooner,
if needed,; by a licensed septic tank uL~ ~e ,._..__Wh; you put into
the system can affect the function of- the septic tank as a treat-
ment stage in the waste disposal system.
St. Croix County residents ma be eligible to receive a grant for
a maximum of 60% of the cost of replacement of a failing system,
which was in operation pri-c,&,_ o ;ftily 1, 1978. St. _Cr-oix County
accepted this program in August of 1980, with the requirement that
owners of all new systems agree to keep their systems properly
maintained. I~
The property owner agrees to submit to St. Croix County Zoning a
certification form, signed by tha owner and by a masterrplumber,
journeyman plumber. restricted plumber or a licensed pumper veri-
fying that (1) the on-eiti wastewater disposal system is in proper
operating condition and (2) after inspection and pumping (if nec-
essary), the septic 'tank is less than 1/3 full of sludge and scum.
Certification forte will be sent approximately 30 days prior to
three year expiration. ~o
`L
I/WE, the undersigned, have read the above requirements and agree
to maintain the private sewage disposal system in accordance with
the standards s" forth,' hiora:ilt,; asset by the Wisconsin Depart- ro
ment of Natural ,Resourcas, Ceir ificetion`'form must be, completed
and returned to' the St. 'Crgtx County Zonin4 Office within 30 d X$
of, the three yir ar axptratioe `de4e• r
SIGNED
' al
DATE 71,v 9 t2
St. Croix' County Zoning ;Office
P.O. Box 98
Hammond, WI 54015
715-7.96-2239 or 715-425-8363
Sign, date and return to above 4ddress.
DEPARTMENT OF REPORT ON SOIL. BORINGS AND SAFETY & BUILDINGS
INDUSTRY,- VISION
1 C P.O. BOX 7969
LABOR HUMAN AND RELATIONS PERCOLATION TESTS (115) MADISON, WI 53707
(1-163.090) & Chapter 145.045)
LOCATION: rO HI UNICIPA LITY: OT NO. LK. SUBDIVISI N NAME:
sE 1lNOy ,2 A2z? N/R U s-PNJ /oil E6AT&
's-TGkolx MP1 QEVi`c6I10,C X36 S-GkoixST NoR I /~Vi~so~ ~I
USE CATEII OBSERVATIONS MACE r
l ]Residence r1J K. U.4JNew ❑Replace JUL. /A /SQ& MuLy ~~QC~
Sol/-s ~ A~7~ '`b *New
< o1L.'S ~-`~N~Z - ~r~(gM t A
RATING: So Site suka(bbN for system U- Site unsuit" for system IN-FIL ONVENTI S ❑NAL: ~ MOUND S' 1V! IN 71S 13U ❑ S . U 0 S TA _ K:IRECOMMENDE
06NJENT D S ATE11+~fo&pt0nal}
P" ' r I If Percolation Tests are NOT required O SIGN RATE: if any portion of the tested area is in the
under s.1-163.09115)(b), indicate: C Floodplain, Indicate Fioodplain elevation:
ASC- P W DESCRIPTIONS
BORING TOTAL T -!kMj; CHARACTER IL WITH THICKNESS. COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH3!(, ELEVATION BS V TO B CK IF OBSERVED EE ABBRV. ON BACK.)
-ORO 16~ EiLLTS !40t3AN L StS►L 12°,6f^ N
B• L 1`3 Rn!
C'SJ 6k r&N C- M S wT6k
Zft "<S 21"9RNSiL-SL /6" ektil C5 -4 4R
B- Z 19,SO 5.`S NE ? -S U "
B- 9.47- .4 -Z Z@~"$LSC-r-- 17*&L 4$kN SL 68` C•M :S W
9S.01- o jg•33 8LCT5 033 Y$RN~fM~I.rRGR,RN SfL / Fgl;
Jz" $r_ SLTS Zo"$RN S,C,tE, $~+v GM S R
B- > q,/7
96.35.
B-
Q FT PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME A MINUTES
NUMBER i S AFTER SWELLING INTERVAL-MIN. 1510115B I PERIOD 2 S223 PER INCH
P_ 3 >z >2 >a <
P- "4o -77 2 > 2 < 3
P- 3 L Q GV Fier t
P- i 4
P-
P-
PLOT PLAN: Show locations of percolation tests, mil borings and the dimensions of suitable soil areos. Indicate scale or distances. Describe what am the horn
zontal and vertical elevation reference points and straw their location on the plot plan. Show the surface elevation at all borings and he direction percent
of land slope. oP £ D
SYSTEM ELEVATION 90.1 ' . _ ON
i I ~ E R: e ♦ ~ ~ - f t- ~ t
c
7,6
e 4
~l:;.r" ~ +s. M1A. 'r.. " d ` i..... I 1 i..d ~r.`L.~ ; +.r d'.~L'.f.:..
S9ST
t.
s:~tIE
Viz ~ +t ~ A ~ I~ 4 I 1 t '
f.az•.: , ~ I e ' 111! i ` f , _ i
s
N 444.
<v
.f3 3w » j i $ { ' Y 1r ,YST ~NQUL.& 44 A,
+ilp W 'F~Ai (A/l T~.f T• j l.?11'~f1`li'~
tr ~]f ...........8..- .~'~r (64-
Fko,ek, 'SY`ST~ f~I Q u E R 1 .
Q t Li DSON t)-T / 0 f~ w AL)*
1, tM u si#ned, hereby certify that the soil t reported on this form were made by me in accord wi pro ures and methods spec n the W sconsin
Ad inistroti Cod` and that the data retx►rdod the kmtlan of the testa are correct to the best of my knowledge and belief. Lor L Nf- Eit-A t.N
t•"lN I~fAG r✓>+li~t~ ~r~►~K~~- -ai,"'" LOTS /0 Mt.
r
A (print): TESTS WERE COMPLETED ON:
4AkVF, Y JL~H 1`-1'%SoM ~UL /S /SaC
ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional):
CST S GN URE:
`k
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Taster.
DILHR•SBD-6395 fly. 02182) - OVER -
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