HomeMy WebLinkAbout022-1083-30-140
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Parcel 022-1083-30-140 02/02/2006 10:28 AM
PAGE 1 OF 1
Alt. Parcel 29.28.18.451 F 022 - TOWN OF KINNICKINNIC
Current X 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 - PRUCHNOFSKI, GEORGE J, & CAROL NELSON
GEORGE J, & CAROL NELSON PRUCHNOFSKI
1059 E RIVER DR
RIVER FALLS WI 54022
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description * 1059 E RIVER DR
SC 4893 SCH D OF RIVER FALLS
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 20.850 Plat: N/A-NOT AVAILABLE
SEC 29 T28N R18W PT SW NE 20.850 AC COM Block/Condo Bldg:
NE COR SEC 29 S 1322.51'S 90 DEG W
1769.62 FT S 550'N 90DEG E 66' TO POB N Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
90 DEG E 397.65'S 764.52'S90 DEG W 29-28N-18W
1305.97'N 657.23' N90DEF E 842.32'N
107.26'N 90DEG E 66' TO POB
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 966/131
07/23/1997 964/287
07/23/1997 725/436
2005 SUMMARY Bill Fair Market Value: Assessed with:
143874 456,000
Valuations: Last Changed: 08/1112005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 5.000 80,000 298,100 378,100 NO
PRODUCTIVE FORST LANDS G6 15.850 83,000 0 83,000 NO
Totals for 2005:
General Property 20.850 163,000 298,100 461,100
Woodland 0.000 0 0
Totals for 2004:
General Property 20.850 80,000 215,500 295,500
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 214
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
i
Form - S T C - 104
AS BUILT SANITARY SYSTEM 10,PORT
OWNER G iQ1k NOrs TOWNSHIP k2M1A/?cir~ r~,_c SEC. T 2 N-R 1$ W
ADDRESS JEfE-Z7 Ay S !N>u ST. CROIX COUNTY, WISCONSIN
SUBDIVISION LOT 11011' SIZE
' PLAN VIEW
Distances and dimensions to meet requirements of H 63
SHOW EVERYTHING WITHIN 100-FEET OF SYSTEM
i
N
Ut
o '
o,~ o
tZ INDICATE NORTH ARROW
BENCHMARK: Describe the vertical reference point used
Elevation of vertical reference point:
Proposed slope at site: 3°l
SEPTIC TANK: Manufacturer: ZCS i23 Liquid Capacity: llbb &44.t.4~4 T
Dumber of rings used: Tank manhole cover elevation:
Tank Inlet Elevation: /4Z. ZZ- Tank Outlet Elevation: /c6.00
Number of feat from nearest Road: Front, 1~uu tt ,rc dl/~ Gc! c_ S~idelRear
- ~V JL 1,06 O feet
9r ' , 2r1D;~l
i
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:
Al.arma* Manufacturer: Alarm Switch Type:
Number of feet from nearest property line: Front, Side, Rear, Ft.
Number of feet from well:
Number of feet from building:
(Include distances on plot plan).
SOIL ABSORPTION SYSTEM
Bed: Trench: r
Width: Length:Number of Lines: Z- Area Built: 92
Fill depth to top of pipe:
Number of feet from nearest property line: Front, Side, Rear, Vt
Q
Number of feet from well: 0 ELL -TviS..te-C
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 0 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:
NElevation of inlet:
Number of feet from nearest property line: Front, 0 Side, ORear, 0Ft.__
Number of fept from well:
Number of feet from building:
Number of feet from nearest road:
Alarm Manufacturer:
Inspector:
Dated Plumber on job: f ,
License Number:
'w/-
D
INDUSTAY, EPARTMENT OF 6 REPORT ON SOIL BORING ILD INGS
LABOR AND Ij v FETY & B D VISION P.O. BOX 76
MAN RELATIONS PERCOLATION TESTS ( 5) l~ ADISON, WI 53707
(H63.090) & Chapter 145.045) ~'yC
FUN ON SECTION: TOWNSHIP UNICIPALITY: L T N.
O.: SU IV NAME:
Zq /TZ8 N R eg E (or [ZrJ Ic Vr-I AjxJ IC.
: OWNER' BUYER'S AME: MAILING ADDRESS:
!7. Lx Geode PIP. ~ t-) >J v s >z 16 1 S Z~
USE RQe S6 MI US) MN SSC/!5/
NO. BEDRMS.: COMMERCIAL DESCRIPTION: DATES OBSERVATIONS MADE
L11b esidence ?New PROFILE ESCRIPTIONS: ER OLATION TESTS:
~ ❑Replace
Go _ s -8 s N . /y .
RATING: S= Site suitable for system U= Site unsuitable for system 1`1_7F 6
CO J 11 ENTIaAL: MpU ~ • IN G19S EJU RE: SY~STEIVI-I2ILLHEI S TANK: RECOMMENDED SYSTEM: (optional)
If Percolation Tests are NOT required DESIGN RATE:
under s.1,163.09(5)(b), indicate: C.~ FOSS If any portion of the tested area is in the C~
Floodplain, indicate Floodplain elevation: /t.
PROFILE DESCRIPTIONS
BORING TOTAL D PTH TO GROUNDWATER- CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH+PF ELEVATION OBSERVED ST. HIG EST TO BEDROCK IF OBSERVED (SEE ABBESS ON BACK.)
S' \•o' 81St) -F-- + ~io•6 RhS4/.2' s %
;-q
6 S - - -
8.6' S-~' II 6'(01 M.9
B- -7.y; 59 6 ' ti 7.9 1' 1•~.' II z-$' 8n s1 `28)l' .SS
> 7•y 1.4' 1•~'B~ Si I ;0.$'8►,SI' 3.yr
(0.'7' °16.-2 o Bl S1 ~S o. Bn ►S S ) Qn `FS
B_Er
BYI 'F S
B-
B- _
PERCOLATION TESTS
TEST DEPTH. WATER IN HOLE TEST TIME
NUMBER INCHES AFTER SWELLING INTERVAL-MIN. DROP IN WATER LEVEL-INCHES RATE MINUTES
PE IOD 1 PERIOD 2 PERT D PER INCH
P-
P_ e
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. IS 03315 I PRae 91 G07111 AV! 1 `I'S
SYSTEM ELEVATION taeha► _ SL qy,o, tioTa: lk.~S LL \-WES `tom IM1'1 NL Bf Yr ^.u
J'p 2 L
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I, the undersigned, hereby certify that the soil tests reported on thi?s form wer2 r~aeb`y 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.
r ME (print):
TESTS WERE COMPLETED ON:
R~i v~. WEGeMe!R 10-\S-8S
'1DDR ESS:
2~y QOK zl/ CERTIFICATION NUMBER: PHONE NUMBER optional):
b 576. 1
~1S-4zS-0/6~/
CST SIGNATU E:
P•
'TION: Original and one copy to Local Authority, Property Owner and Soil Tester.
9395 (R. 02/82) - OVER -
ii STFi _r_ w 'L_T77` 7C" 1 r-mS 3-6396
Td i acr
1. C' i
' A HOLDING TAN ALL
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DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY dl BUILDINGS
LABOR & HUMAN RELATIONS
P,O,BOX 7989 PRIVATE SEWAGE SYSTEMS DIVISION
MADISON, WI 63707 BUREAU OF PLUMBING
* MCONVENTIONAL DALTERNATIVE Btote Plan 1. D. Number:
r
❑ Holding Tank ❑ In-Ground Pressure ❑ Mound (If saignM)
NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER INSPECTION DATE
George Pruchnofski 11015-27th Ave.SE, Mpls., MN 55414 / 0.-/9-y6
BENCH MARK (Permanent reference Pomt) DESCRIBE IF DIFFERENT FROM PLAN REF. PT. ELEV.: CST REF. PT. E L E V
SW NE Section 29, T28N-R18W, Town of Kinnickinnic
Name nl Plumber MP/MPRSW No. Cnun)y. San,tary Per-,t Number:
Paul Cudd 2739 St. Croix 79214
SEPTIC TANK/HOLDING TANK: 03
MANUFACTURER . LIOUI CAPACITY TANK INLET ELEV. ITANK OUTLET ELEV. WARNING LABEL LOCKING COVER
y` PROVIDED. PROVIDED.
BEDDING: wVENTDIA.: / VENTMATI HIGH WATER YES ONO OYES ONO
ALARM NUMBER OF ROAD. JPROPERTY WELL BUILDING. VENT TO FRESH
'Y/ n FEET FROM LINE AIR INTO
YES ONO 1, Oc OYES ONO NEAREST pIF/
DOSING CHAMBER:
MANUFACTURER EBEDDING LIQUIOCAPACITY PUMP MODEL PUMP,SIPF/ON MANUF ACIUHEti WARNING LABEL LOCKING COVER
PROVIDED. PROVIDED.
NO OYES ONO DYES ONO
G ALLONS PER CYPUMP AND CONTROLS OPERATIONAL UMBER OF PROPE HTV WELL BUILDW(i VENT TO FRESH
(DIFFERENCE BETFEET FROM LI"E 41R INLET
PUMP ON AND OFOYES ONO INEARES711IA-E SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE F N(,nI TI Il 41A11 11141 AND MARK IN I,
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 UISTH PIPE SPA(:W(, COVER NSIL'L ..A =PITS LIQUID
THFN(]i►ES t//y' rl IAL' PIT DEPTH
4A ~7 I? DIMENSIONS
GRAVEL OFPTH FILL DE TH UISTH PIPE DISTH PIPE. DISTR PIP,Fj MATERIAL NO II NUMBER OF pHOPERTY WE FRESBF LOW PIPES ABOVE COVER EI E/,/ pl
AIR NIT TO
NLET
/(/!/FEET FROM V
NEAREST-
MOUND SYSTEM: 3
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-
OYES ONO meets the criteria for medium sand. TIONS MEASURED.
SOILCOVER TEXTURE PE HMANI N I MARKk 1/5 OBSERVATION WE LLS
ONO
DFPTH OVER TRENCH BEO DEPTH OVER THEN(:f/ HEO TH OI TOPSOIL O YES OYES
5()111 )f O SEE Uf l) ULCHED ONO
E NTEEDGES
I
OYESONO OYES LNO rl
YES ONO
PRESSURIZED DISTRIBUTION SYSTEM:
BED/TRENCH WIDTH LENGTH NO. OF LATE HAL SPACING GRAVEL DEPTH FL OW PIPI FILL DEPTH ABOVE COVER
TRENCHES
DIMENSIONS
MANIFOLD PUMP MANIF OLU DISTR. PIPE MANIFOLD MATERIAL Nn OISiH I)ISTH PIPE UISTH)BUI ION PIPE MATEHIAL & MARKING
ELEV. ELEV CIA ELEV. PIPES DIA
ELEVATION AND
DISTRIBUTION
INFORMATION HOLE SIZE HOLE -SPACING f)NILtLDC0RRFCII Y COVEHMAIEHIAL VERTICAL LIFT CORRESPONDS TO APPROVEO
PLANS
DYES ONO OYES ONO
COMMENTS: PERMANENT MARKERS- JOBSERVATION WELLS. NUMBER OF PROPERTY WELL. BUILDING:
- FEET FROM LINE
,4 F' OYES ONO OYES ONO_ NEAREST
3I
Sketch System on Retain in county file for audit.
Reverse Side.
SIGNAT D ~ TITLE
DILHR SBD 6710 (R. 01/82)
unsconsin APPLICATION FOR SANITARY PERMIT
~ D1LHR St. cr01X COUNTY
- OEPR4lTTE1"IT OF
(PLB 67) UNIFORM SANITARY PERMIT #
InOUSTRV,LRBOR&HUMRn RELRTIOnS w ~
~ /VLj>J
-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
George Pruchnofski 1015-27th Ave.,SE, Minneapolis, MN 55414
PROPERTY LOCATION X X
SW 1/4 NE 1/4, S 29 , T28 N, R 18,,ec(ca) W I TOWN OF:
LOT NUMBER BLOCK NUMBER SUBDIVISION NAME NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER
River Road
TYPE OF BUILDING OR USE SERVED Cow ^ 10LY 1 or 2 Family Number of Bedrooms: 3 ❑ Public (Specify):
THIS PERMIT IS FOR A:
IN 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 ❑ 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 Steel Fiberglass Plastic
Gallons Tanks Concrete Constructed
Septic Tank Capacity 1000 1 X
Lift Pump Tank/Siphon Chamber
Holding Tank capacity
Manufacturer: Wieser Concre e ro uc S
IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: ❑ Mound ❑ In-Ground Pressure
Total #of Prefab. Site Steel Fiberglass Plastic
Gallons Tanks Concrete Constructed
Septic Tank Capacity
Lift Pump/Siphon Chamber
Manufacturer:
PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY:
(Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet):
Class 2 945 948
❑ 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): Si 7tjr e: NIP/MPRSW No.: Phone Number:
Paul R. Cudd RSW2739 (715) 425-2049
Plumber's Address: Name of Designer:
Rt. 5, Box 364, River Falls, WI 54022 Art Wegerer (576)
COUNTY/ DEPARTMENT USE ONLY
Signature of Issuin Agent• Fee: Date:
❑ Disapproved
❑ Owner Given Initial
0 I
Approved Adverse Determination
Reason for Disapproval:
Alternate course(s) 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 t
r
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,
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 may be 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
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 Cxeog & -pay-1FNprts V, i
Location of Property 50
Section o2 , T a8 N-R C~ W
Township Kf nn4, k iy% td
Mailing Address 10! S Q,-?Tj4 St:
Address of Site 0_1 LW_
Subdivision Name,
Lot Number rt. A _
Previous Owner of Property (jPrUjA'~
Total Size of Parcel C20
Date Parcel was Created
Are all corners and lot lines identifiable? Yes No
Is this property being developed for resale (spec house) ? Yes No
Volume 795 and Page Number L{~ 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) eenti,6y that aU statements on this botcm a&e ttule to the but o6 my (outs)
knowledge; that I (we) am (one) the owneA (s) o6 the pno pent y de,S cA bed in this
in4o, mati,on So&m, by viAtue o6 a watAanty deed %eco&ded in the 046ice o6 the
County Reg-usten o4 Deeds as Document No. ; and that I (We) pnesent2y
own the pttopo~s ed site Ooh the .6 ewage d us pats s y6 em (o& I (we) have obtained an
eatsement, to nun with the above dacAi.bed ptopeAty, {Yoh, the eon6tnucti,on ob said
system, and the tame has been duty tecmded in the 04biee o6 the County RegizteA o6
Deedb, a6 Document No. -(d Lo80 S
SIGNATUI& OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE)
9- EAt , F:~ //(o R' Cp
DATE SIGNED DATE SIGNED
-z
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ST C- 105 r
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SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County z
d
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OWNER/BUYERS rf2uc,~,vaarblr } y
ROUTE/BOX NUMBER 4k.),- S Fire Number
~nn* P0(_]s). Ir
CITY/STATE T . ZIP 5j)y
PROPERTY LOCATION: SW k, t4 12' !4, Section 2-1 , T2-1N, R ,W,
Town of , St. Croix County,
Subdivision , Lot number
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 ~
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.
SIGNED
9t`,
DATE A05 LS .196(9
~
C
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.
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'4" , dT.OF REPORT ON SOIL BORINGS AND SAFETY
PERCOLATION TESTS (115
1
P 1_,ATIONS MADISON 'r
• (H63M(1) & Chapter 1,45,045)
r ' - SECTION: -.-TTOt^JNSHI~UNICIPALIT S F -
v ~T JO BLK...JO UBDIV~SiON .vAM~
1/4 -
`Y J OWNER' BUYER'S NAME: MAILING ADDRESS
^J
USE DATES OBSERVATIONS MADE
NO. BEDRMS.: COMMERCIAL DESCRIPTION: D Replace DESCRIPTIONS: PERCOLATION TESTS.
! `tj~e:idence New ~JReplace _ 1S-8S N A
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENTIONAL MOUND: ❑U IN GRO'JVD-P~ URE: SYSTEM-IILLTHI,LDINGNK: RECOMMENDED SYSTEM: (optional) 'I
>(j U
- _ -
P rcolavon Tests are NOT re aurred DESIGN RATE LF er- - - -
S c y portion of the tested area is in the
under s f63.09(5)(b), rrrdreate' oo dplain, indicate Floodplain elevation:
PROFILE DESCRIPTIONS
BORING TOTAL DEPTH TO GROUNDWATER- CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH+N ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.)
- -7'6' t~Y~NS > `~•6' 81St TS j ).S- Bn.5 1 9 6~8ns` i_yZYBh_'~S.
3 z' N > 6-Z' 1.3' tt - y.q'
B 6. 6' ~?6•S' a > 6.6' o•~' ti S-~' 11
5
B- -~•y' qq.~ ' +I > 7 L/' W4' N ; 1•~' "Sh SN ;o.16' i~h 3 5/r~( Qnfs
6.7 ` 1s o FJ C-_
Bh lS ; S•)'
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 t PERIOD 2 PERIODS _ PER INCH
P-
P e
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 land percent
of land slope. 3.5 ' PR C- E 9 GOTH AN t S
SYSTEM ELEVATION ~`~che.►r- 9y.o' r•~o ~-QE_~7 io I►.1`nRL E;, 4u
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i . _a I ? DIJ
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5 i
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X~~PT R,5 Q, ~J )/q fJE1/y SctrT.~ 29
I, the undersigned, hereby certify that the soil tests reported on t is form were ma a 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.
~,4ME (print►:
TESTS WERE COFJIPLET ED ON:
'r RESS: - CERTIFICATION NUMBER PHONE NUMBER(optional):
I^ D
y '°'y~x - ~u,Swotz;'•~,wJ, Syo~) 5"'~0 ,,i,- y~S-01b~
CST SIGN/A/TUFJE
,iBu 110N- C i pop}' to Loco ~~?hor t Fr.;P rty 0vner and Sort Tester.
DiLHR SBD-6395 (R. Oi'S2'i - OVER -
G4azS'I~~e:- PTzy~ F-k ►J_-"F ;-S C-i
Owner's name San. Permit No.
H63.05 PLOT PLAN
Show:
~ " r Location of building served Na Dosing chamber
0 Septic tank E Vertical/horizontal reference point
Q Building sewer Q System elevation is o13 S t
F Effluent system Q Well
Q Replacement system area NA Property lines w/in 50' of system
Q Distribution boxes F-I Scale = ~t~= qC) , or dimensioned
NA Pump and controls:
Mfr. & Model No. Vertical Lift Size Force Main
.Friction Loss T. D. H. Vol. Dist. Pipe Gal..per Min. Gal. per Cycle
Place check mark in appropriate box, indicating item is shown on plot plan below:
$,M wood sYn:s
1 t3A►.~ Pt Pc w / L A-r)-j
tel. lob, p'
•
4t RAC ~I
Pv C atSZTZBultur
_ C~tPE S 3
y~_ N
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I
QJ~ - PaEA _ ~J. In
S3'
GAR • ~
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w~.~,) 5 looo ~A~,wiES~. c.cwe. .20~~ ~3t-tBNRP
SEPTt C 17t-N~ ' 1 1~►J P ~ F'E
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I
1vE KV C.T ~-u T V t N r-
By the granting or approving of the above plant or upon the event of a. subsequent
permit being issued, St.Croi.xCounty and theSt.CroixCounty Zoning Administrator, does
not assume or hold itself liable for any defects in plans or specifications, plan
omission, examination oversight, construction, or any damage that may result in or
after.. installation.
um r s signature icense o. a e
r~• ~r . 3/
• v.~ w ~z S ~ J h h E
CROSS SECTIDM - OF A BED 5-'3STEM
Y~L
~r,vlS App 14 L- 1 S n1J -4- SOIL FILL Z" OF AGGREGATE
DISTRIBUTIOIJ PIPE
APPROVED SyUTHETIC COVER
MATERIAL OR 9° OF STRAW
OR MARSH VAA.3 '
"'°~dttfo.ao o°
. (e"OFUGGREGATE OF q3.S FEET-.~
DISTRIBUTIOU PIPE TO HC AT -LEAST_.IIJCHES BELOW ORIGIIJAL. GRADE
AUD AT LEASTP-O IIJCHES BUT MO MORE TRAM 42 IUCHES DELOW FINAL GRADE
MAXIMUP% DEP:-H OF 1-XCAVATIOIJ FROM ORIGIQAL GRADE VJILL BE -Y~ IUCHES
MINIMUM DEPTH OF EXCAVATIOIJ FROM ORIGIIJAL GRADE WILL BE- INj CHES
SIG/JED:
LIGEuSE kiUMBER: