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HomeMy WebLinkAbout022-1089-70-000 ~ -0 0 0 G `i1 o 3 rel. 'U 7! • O v h O O c 0 -4 co N 7, w O N C co R O 5 N N • M-0 CD 3 3 O_ z z N ? fD n CO p = `Al c: CD CD po 00 N O. O O rn C~. co ^S O 0000 c 7 7 CD < n 00 O - 00 co CO --I n o O D O C W ~ 7 Of O !Y 10 CL cn i.. O N 0 (n w v, O Sf ; Wz cn { N m~ Q03 : N "O'' C a v v m oz OOO -n "44. n" a In to In O CD CD voq~'Io N CD N a) PO CI O N N 7 N O. z z 3 N u o z -1 z 0 n" D m O o 0 n CD c w tv N O C (a I w ~ ~ a n 3 (D I E z CD (p a -i G7 O CA : A v CL p z 6 M N O m (D m m co z a 0 3 c (n 3 m ED N ~ CD ? W ~ 0 CD Q N O p) CL C .7-. a " N w O O" 3 v T O -0 C m o o a ((D p x 0 ~o a oC. 00 < A CL 4 4,0 o CD A O V 3 w A CD O N (D J O CL A a o ^ ti zi b (D bhp W rn O o CD 4 b o 'I Parcel 022-1089-70-000 04/17/2007 12:06 PM PAGE 1 OF 1 Alt. Parcel 30.28.18.P480B 022 - TOWN OF KINNICKINNIC Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 05/16/2006 00 6 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - KLACAN, RETIRED RETIRED KLACAN Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 4893 RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 1.000 Plat: N/A-NOT AVAILABLE SEC 30 T28N R18W PT SE SE COM 1225.8'W Block/Condo Bldg: OF NE COR, TH S14DEG E 94 1/2' TO CEN LN TN RD & POB: S14DEG E 272.3' N75DEG E Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 160' N14DEG W 272.3 FT TO CEN TN RD WLY 30-28N-18W TO POB (CSM 20-5172 WAS CREATED) Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1100/234 WD 2007 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 05/16/2006 Description Class Acres Land Improve Total State Reason Totals for 2007: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 n co o 3-0 n d r~ 0 f ° co ~/1 V CD ^ n O O y p (CO a) O N O 3 3• 3 C fD 7 N N FBI CD m 00 O 3 O fD ' 5 co t m to N yr v 1 8 au I n 7 7 CD _ O A O O O co OD co O N -1 O O 7 y 3 O W OO wr. N N co (n D eo a A co O c N W C1 v+ C p 4 rv 3 o rn i :3z a w O CT r zz CL o a' 7 x, ny I CD OD CD G' co r or . Q Z N f tyiy 'O V V v "me (D ~d i i N $x7 A O O C O ti rt tR7 n v O P. W n c N N C*n m "a CD F- I O O _0 N eD A ur V H cn m V N 90 t-4 CD N O H i,~ H~ I e~D N CL N 9 o (D 0 d ~ o D0' O v CD o =r V I (~D r y • N X N ~ll~_ll O N CD c 7. 'D N 2) CD Oo W w m 06 rn 1 I o 3 5 oZ j C a z CO) cn a CO CL A ; Z ~ I 7 O I fn W b rh ~ W m co x 00 a Z Cl) E2 n m 00 rt 3 x 0 w n D 3 O m a n I 5'i a o 3 m c o o a 0 m ~ I n I I ~ a, I I I o a ~o I ~ ON I ON I c A O b cn I O oq N c O o °o r I~°• Ora" ^ ~ y ~ r ( o m A > C ~1 o tv ~nbcDw~nro m ca oC 0 H. 0 p :4 Fl- `Y rs •d o w n o oo z' • 10 OM no cvw~wao C M M o .l 'b cr ohm Q O ~b f0 w v~O 14 o o "how m~u°r~ccDID ICCF) P. H- 0 B eow , rv s. mix 0 ti A, Co n diAPPnovLtl a / yti r' DEPT. OF INDUSTRY, LABOR & HUMAN P r \ / DIVISION OF SAFET h1D WI. R 'a SEE CORRESPONI ENCE ° eq c U1• v ' J N o~ o 0 Al ' ,tea ` \ b F{~ rm - S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER QNL.t.SgWl ~A'itE. eK TOWNSHIP ~r11~2~KLNI~~, SEC. T N-K _W ADDRESS ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H 63 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM o WELL. 7 a _ Y pz~c~ , ~ q ~iM N ` INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used IeLay"age Vf_p• tuRomec O L_O- Elevation of vertical reference point: 160.60 _ Proposed slope at sit.e: fo`~a SEPTIC TANK: Manufacturer: Liquid Capacity: Number of `rings used: Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: ~b-a7 Number of feet from nearest Road: Front,o Side 10 Rear, o feet From 4nearest property line Front, Side, Rear, feet Number of feet from: well building: (Includ:e this information of the above plot-plan)( 2 reference dimensions to septic tank) 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: Alarm Manufacturer: Alarm Switch Type: Number of feet from nearest property line: Front, ~S.i.de, O Aear, 0 Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench:_ , Width: ' Length: [1 Number of Lines: 1 KCEMCIA Area Built: '750 _ Fill depth to top of pipe: 2-6 Number of feet from nearest property line: Front, /O Side, O Rear,0 Pt Number of feet from well: ©Ir- 1l4~ Number of feet from building: (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Are'a"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, ORear, OFt._ Number of feat from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: Dated: Plumber on job: License Number: 3/84:mj Wisconsin APPLICATION FOR SANITARY PERMIT (~IDILHR St • Croix COUNTY (PLB 67) OERfiRT TEnT OF UNIFORM SANITARY PERMIT # InOU5TRY, LRBOR 6 HUTRn RELRTIOns --Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8/2x 11 inches in size. -See reverse side for instructions for completing this application. PLEASE PRINT PROPERTY OWNER MAILING ADDRESS William Paterek Rt. 2, River Falls, WI 54022 PROPERTY LOCATION SE 1/4SE 1/4, s30 , T 28N, R18 E W ~ Kinnickinnic LOT NUMBER BLOCK NUMBER SUBDIVISION NAME NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER Quarry Road TYPE OF BUILDING OR USE SERVED - 1 or 2 Family Number of Bedrooms: 3 Public (Specify): THIS PERMIT IS FOR A: ❑ New System ❑ Tank Replacement ❑ Repair A Replacement Soil Absorption System ❑ Revision ❑ Privy ❑ Alternate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. ❑ Seepage Bed 1?; 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 - El An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions. Total #of Prefab. Site Gallons Tanks Concrete Constructed Steel Fiberglass Plastic Septic Tank Capacity ExiStin Tank 1000 1 X Lift Pump Tank/Siphon Chamber Holding Tank capacity Manufacturer: 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 2 750 750 FK1 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 ure MP/MPRSW No.: Phone Number: Paul R. Cudd PRSW2739 (715) 425-2049 Plumber's Address: Name of Designer: Rt. 5, Box 364 River Falls, WI 54022 Arthur Wegerer (576) COUNTY/DEPARTMENT USE ONLY Signature of Issuing Agent: &dt4,,j L,2v, Fee: Date: ❑ Disapproved /~S^Q© 6 -13 -9-< Approved ❑ Owner Given Initial V f Adverse Determination Reason for Disapproval: f 61 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 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, etc.); 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. DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS P.O. BOX 7969 PRIVATE SEWAGE SYSTEMS DIVISION MADISON, WI 53707 BUREAU OF PLUMBING CONVENTIONAL -1 ALTERNATIVE State Plan LID, Number: Holding Tank ❑ In-Ground Pressure ❑ Mound If assigned NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER MSPECTION DATE. William Paterek Rt. 2, River Falls, WI 54022 ~-~1- BENCH MARK (Pe(manent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PL ELEV.. SE SE, Section 30, T28N-R18W, Town of Kinnickinnic Name of Plumber: MP/MPRSW No.: Cnu nty. =,,7Perm,t NumberPaul Cudd 2739 St. Croix 194 SEPTIC TANK/HOLDING TANK: MANUFACTURER: 3 ' LIQUID CAPACITY. TANK INLET ELEV. T NK OUTLET ELEV.. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: DYES ❑NO DYES ❑NO BEDDING: VENT DIA.. - V N MATT JHIGH WATER NUMBEROF pROPERTV WELL BUILDING. ALARM FEET FROM LINE JVENTTOIRESH AIR INLET: DYES ❑NO DYES ❑NO NEAREST DOSING CHAMBER: MANUFACTURER BEDDING. LIQUID CAPACITY PUMP MODEL PUMP;SIPHON MANUF ACTOLIER WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: DYES ❑NO DYES ❑NO DYES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF PROPERTY WELL BUILDING I VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET: PUMP ON AND OFF) DYES DN0 NEAREST 11, SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing i,lAMf rER IIATEHIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until LFORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: 57 LENGTH ND OF DISTH PIPE SPACING COVER NSIDE )IA -PITS LIQUID ~J TREN' S MhFf HIA L: PIT DEPTH. DIMENSIONS W\ BED/TRENCH EABOVECqVgR 1,R V, F L DEI'Tl l DISr R PIPPIPE DISTR PIPE MATERIAL NO DI t NUMBER PROPERTY WELL BUILDING. VENT TO FRESH BELOW PI ES ELV INLE ELEVEND OF PIPELINE FEET FROM S gkRLE,4 NEAREST-_ J~ 1 ..d Ie" d 7I 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 NO meets the criteria for medium sand. TIONS MEASURED. D SOIL COVER TEXTURE PERMANENT MARKERS ORSEHVATION WELLS DEPTH OVER TRENCH BED DEPTH OVFH TRENCH BEU DEPTH OF TOPSOIL SODOfD DYES ❑NO SEE UFD DYES MULCHED ❑ NO CENTER EDGES DYES. DNO I1:1 YES CNO DYES ONO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH LENGTH NO.OF LATEHAL SPACING (TRAVEL UEPTH BELOW PIPE FILL DEPTH ABOVE COVER TRENCHES. DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL -0-15 ISTH DISTR. PIPE DISTRIBUTION PIPE -MATERIAL & MARKING ELEVATION AND ELEV.. ELEV. DIA ELEV. PIPES DIA: DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING; DRILLED CORRECT LY COVER MATERIAL VERTICAL LIFT COR RESPONDS TO APPROVED PLANS DYES ❑NO _ DYES ❑NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS NUMBER OF PROPERTY WELL: BUILDING: FEET FROM LINE r L1 YES ❑ NO YES NO I v ` EAREST_ 2,7 12 . z7 SI Sketch System on in i ounty file foi- audit. Reverse Side. SIGNAAT~UidRE: TITLE. DILHRSBD6710(R.01/82) 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 1011-[.0 fn V -r04EH A).~- 1~AT fir-+-c Location of Property _!~,E , Section T N-R~ W Township K 1 N "i GIC / N N 1 c Mailing Address 13 pk a2 y I?d20 = '2- E ivEa EAU-5 L21 icezvs t /U 12 Address of Site Subdivision Name Lot Number Previous Owner of Property g~4p7 Total Size of parcel Date Parcel was Created Are all corners and lot lines identifiable? jC Yes No Is this property being developed for resale (spec house) ? Yes X No Volume and Page Number// 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) ceAt.46y that aU statements on this 4otm ate true to the best o6 my (out) knowledge; that I (we) am (ate) the owneA (,s) o4 the ptopetty dens ctc i.bed in this in4otmatt,on 4otm, by viAtue ob a waAAanty deed tecotded in the 044ice os the County Reg.ustet ob Deedd as Document No. 3Z? j - and that I (We) pte~sent y own the ptopoz ed site Ooh, the sewage d igs pops yes m (ot I (wel have obtained an easement, to tun with the above descA bed ptopetc.ty, bot the consttucti.on o4 said .6y6tem, and the same has been duty tecotded in the 044ice o4 the County Register o6 Deeds, as Document No. w. SIGNATURE OF OWN R NATURE OF CO-OWNER (IF APPLICABLE) 2~ a3~ 9 DATE SIGNED DATE SIGNED i' L/., ti • j, S T C - 105 r y ~-i SEPTIC TANK MAINTENANCE AGREEMENT H St. Croix County C 0 y OWNER/BUYER !.(9 l LL1 /j(M V, T SF~ f ROUTE/$OX NUMBER t3OX 2_';V J T7z-- -2 Fire Number i4a 6~ CITY/STATE R1yL=j2 FALL-SO42(SC0&J4i/y ------------Z1P-- PROPERTY LOCATION: _f,F7 %a, Section 0 R_1 `7 W, Town of j N1V1 c-ts.L9/~71 c- 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 607 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 system's properly maintained. The property owner agrees to submit to St. Croix County Zoninj, 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. ti 0 E I/WE, the undersigned, have read the above requirements and agree N to maintain the private sewage disposal system in accordance with x the standards set forth, herein, as set by the Wisconsin Depart- o 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 St. Croix County Zon_nb Office P.O. I, ox 98 Hammord, WI 54015 715-7~ 6-2239 or 715-425-8363 Sign, date and return to above address. p N r tC m y . O O N w =31 7 0 =rD c O O N cD a 7r o c; m O cc 1 3 -o Z C O o C N m 'Cr =r 1 •D0~D' vamCDZ-0 a ch CD .l o - CD o :3 jj u M :3 CO CD v 0 x 0 m M :91. .4 CD W n N O CO n o m a o m -G~' c (D (a 3. (a 0 Z C `G _Q j * O n w.. ~A,wc'n O cD p 0 O CD cD w . M c" 0 < CD N N ' co Q O (p C D o' w o w o 2 o° aQ~ w O CD (a :3 =r -0 W :3 , (n CD 4) Cn =r A) CA 0 _Z 0 0 CD co co m CD 0 =r u CD aCDo 3 CD CD ?a (n C CD =r o a r.w =r o O 171 ar (D m v, w =r CL Cl) Imo va,'uc,ww0~ C ITI o S S CD C p a cD ? ~v,(D v, m~wv, M ' n ~U:) W ON Q0 S -0 0 On CCD ca n co, N 'a o c c - m 171 wow a w o =wN= cr (n m ca c co w =r CD :2 U, O 7 C CD cD 3 y A a 0 O o cc a O w vi a C w , (D cD C O O = c a c CD w= o Y~ CL 3 0- 0 m a c ~ o~ ® co - N 0 Z DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, G DIVISION LABOR AND PERCOLATION TESTS (115) MADISOP.O. BOX 7969 HUMAN RELATIONS N WI 53707 (H63.09111 & Chapter 145.045) LOCATION: SECTION: &TO W NSHIPN~UNICIPALITY: OT NO.:BLK. NO.: SUBDIVISION NAME: CC~N>c ~>Jw tc - - - 000NTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: ~pVTi~ Z 'zM CW w lr~~ wh Pam R.►uER t=ALL ,3 tvl s z. USE DATES OBSERVATIONS MADE NO. BEDRMS,: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION EST: Residence '3 A ❑ New Replace S - S-S U )v - k - 5-16-8L Ceyoas RATING: S= Site suitable for system U= Site unsuitable for system r ONVENTIONAL: MOUND: 11V-GR~~O77IUND-PRESSURE: ISYSTEM-1 N-F ILL HOLD INGTANK: RECOMMENDED SYSTEM: (optional) o s ❑U ®S ❑U ICI S ❑U ❑ S ®U ❑ S ~II1ffU S`t ►,►c~tFs -EACH S 'x_ 3o, L_Dn~ If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the under s.H63.09(5)(b), indicate: C L►PcS S 2 Floodplain, indicate Floodplain elevation: N• P`• PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-IN851ES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH j#. ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B-~ £S.0~ Qg,(0I }Je,rvE > 6LTs; i~'8nS1, 5•rJ~~n Is B- 8•2-' ~O~.Z~ I~n►JE > Z` t3'-DkGYbnLTs; N-1' :8 nSI~ s,S'Bn[s o`D B- 3 S.Z~ 1Ob.3' IvOt ~.Z' ~.,k GYan LTs; 0 6~Bns~I~o.~'Bn s~ B- 8.%4 q°l.0 NOAJ~E > S.4' 1'3~D~6,~$>1LTS;t3'$ns1l ;o•6f@►,s1 jS.Z~3>1 1s 13- B- PERCOLATION TESTS TEST DEPTH" WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD1 PERIOD2 PERIOD 3 PERINCH P- P- P- As PtM JL 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 locatio n the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. © CIZ•1' (S) Qb;l' q4.Z ' ~~i92 Cy J D~'~eoTA LoAw► SYSTEM ELEVATION CD c"(4' CO 9(-r' ~X I _ T )i~ n # 94 A,-7 U 16 I ( s ( fJ 'SG J~D V T}4 1 f s ' 5o1E5..` _ i- [ • 1T F Ttt FJ ~r SEllir~s r ~o ~ N E m 3 t i I ~ I 1 4)1'1 ~ 03 E I I cml I = f jj ( WE L r I 3 I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. ' NAME (print): -t~ TESTS WERE COMPLETED ON: "xmv? L, s-l6-86 ADDRESS: 2-T U px Z2 CERTIFICATION NUMBER: PHONE NUMBER (optional): LL w w S y01 S-7 ~ 1-71 S- vas-o/ 6 CST SIGN TU E: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - L 'r"L--r at if-TION FO r AN r:TIN np 115 - C - Tc r :e soil to 1e 2. e C ONLY IF ALL. ti x; THE AT -FIE- SIC v r~ J Owner"s name San. Permit No. H63.05 PLOT PLAN S how : i f Location of building served Dosing chamber Q Septic tank L_J Vertical/horizontal reference point m 98-1' ar> 9&.C Building sewer CSI System elevation is(2) 9-)•y' Cs) 3y.?' U F Effluent system Q Well MP1 Replacement system area Property'lines w/in 501 of system 1.1~\ Distribution boxes Scale = \kk- 30 J , or dimensioned Nq Pump and controls: Mfr. & Model No. Vertical Lift Size Force Main Friction Loss T. D. H. Vol. Dist. Pipe Gal. per ,Lin. Gal. per Cycle Place check mark in appropriate box, indicating item is shoFm on plot plan below: EL 9s? an~i t'Z.•~oo.o' a..~ ~ GoF ~ElE4NO►aE Box ls3 .o' HAP 30' _ S4 61 ` "Pvc. ll~ApE2 ~p~ Pt ~ ~ v o.,T s -.u C6 12CO0 U o- 10 ~I $Z 30--- S I of II "tz 'L <Z rj L G" 03 W i }1 !-joy Sa By the gran: -1q or Qproving of the above plan, or upon the event of a sub-sFque Permit beinv: i ~u~^- Hof a dour ty and the "..,roi:C ^nty Zoning Adrm_inistrator, '.oe_, not assure or hplr? :t~,elf liable for any rlei'cts -n _-,,Inns or specifications, pl,-in 3'" i (1 OVE rSi GCI cOi15Lr11C on, o- _-.:i that may r?sult ir, oC installa _on. 's s l gn -ur Ti . c? v Dal o `Ll 0 0 Q ~D W 13 z t~ c~ c M LO po _ ul d 2 rL < N 'O ~ Q 3 r1) uj :2 0 ~a 3~ p= a~ g w w w a. W o m V, z d D ~ ~ Z) 2 ~ _ L F ~r (~1 a' N n' d v 'r 3 u i11 ~ D U) F ~ ' ct S J c F Q pct V1 LL W I.L 0 c~; _a U 7 ~ ~ll Nd~ ~ X 2 l~ ~yi SS Jl N 3 ~.wi Parcel 022-1089-60-100 04/17/2007 11:00 AM Alt. Parcel 30.28.18.480A-1 PAGE 1 OF 1 Current X ST. 022 -TOWN OF KINNICKINNIC Creation Date Historical Date Map # Sales Area Application # Permit # C Permit Type COUNTY, WISCONSIN 05/16/2006 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner PHILLIP G & PAULA S KLACAN O - KLACAN, PHILLIP G & PAULA S 935 QUARRY RD RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): ' =Prima Type Dist # Description ry SC 4893 RIVER FALLS " 933 QUARRY RD SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 8.550 Plat: 5172-CSM 20-5172 SEC 30 T28N R18W PT SE SE CSM 20-5172 LOT 1 (8.55 AC) Block/Condo Bldg: LOT 01 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 30-28N-18W SE SE 0'7 t r P SV(-I Parcel History: ~ Z , 3 Date Doc # Vol/Page ~%~~,~ype e 03/09/2006 820432 20/5172 g CSM D /('0-0 Z 002/14/2006 7/23/1997 818546 /M WD 07/23/1997 740/260 D qv►'d 0. L,e rsn, 2007 S MARY Bill more... Fair Market Value: Assessed with: /D Jp--7d- 00) 0 Valuations: Last Changed: 05/16/2006 Description Class Acres Land Improve Total State Reason Totals for 2007: General Property 0.000 0 Woodland 0.000 0 0 0 0 Lottery Credit: Claim Count: p Certification Date: Batch Specials: User Special Code Category Amount Total Special Assessments Special Charges 0.00 00 Delinquent Charges 0.00