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HomeMy WebLinkAbout032-1098-10-100 0 to O 'i 3 m o d c > > 3 nl. 3 lD T A (on p~ W N • n A~1 N fNJI O O c 3 N O m 0 0Np d CD C C CZD a y CD N CO m 3 1 jZ3 ° w m N G) -I o k~ Q I °o 9 o W A~ rn H N W , 7 y Q. j o O lr m N A m m co W a CD 0? c a 0 3 O w c o A OCI) or c C 't l. o coo 00 0 tin a) a 3 c cl) ; N t7 F'• rt CTJ rn O 0 • O O O 3 o w o rt DC G~ o W o w z F- H In n a c CO) CA (D D v 3 w T a o o ao a rn to 00 E o w y Ar IQ 3 N a 00 a H O 0 o D co l M rt, o F_ CD CO ol U) N a c m I w m a m -4 fR - Z =3 A Z m H H 00 G) pd 0 00 bd ~n FMi V :3 Z -i w W y I'D C/] W M W cn n I :E~ (D Z a o 0 a 3 A;o (D H O " z ti 0 n N z (CDQ ;Z CD • rr t W C.0 I ~ _a I o r. ~ I 3 m ~ 0 0 ~a W m 0) a a o A 7 I ~ I ~ I o- m t N N Q O q A O b CD A Cn 69 0 ti CD t puu%ut-ld,fjuuo,~z~oa~x'IS 11/2212006 11:05 AM Parcel 032409840-100 PAGE 1 OF 1 032 - TOWN OF SOMERSET Alt. Parcel 35.31.19.456B ST. CROIX COUNTY, WISCONSIN Current X! lication # Permit # Permit Type Creation Date Historical Date Map # Sales OArea App 00 Owner(s): O = Current Owner, C = Current Co-Owner Tax Address: O -CRISWELL, DANIEL L &RUTHIE J DANIEL L & RUTHIE J CRISWELL 1813 CTY RD I SOMERSET WI 54025 * =Primary Districts: SC = School SP = Special Property Address(es): *1813CTYRDI Type Dist # Description SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 3.000 Plat: N/A-NOT AVAILABLE SEC 35 T31 N RI 9W NW NW 3AC THAT PART OF Block/Condo Bldg: LOT 1 CSM 6/1748 EXC PT TO PARCEL DESC Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 1034/378 ASSM'T INC P4576 35-31 N-1 9W Notes: Parcel History: Date Doc # Vol/Page Type 10/06/1998 588439 7136613/1/210 07/23/1997 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Last Changed: 07/24/2003 Valuations: Class Acres Land Improve Total State Reason Description RESIDENTIAL G1 3.000 48,000 173,500 221,500 N Totals for 2006: General Property 3.000 48,000 173,500 221,500 Woodland 0.000 0 0 Totals for 2005: General Property 3.000 48,000 173,500 221,500 Woodland 0.000 0 0 Batch 125 Lottery Credit: Claim Count: 1 Certification Date: Specials: Amount Category User Special Code Special Assessments Special Charges Delinquent Charges 00 0.00 0.00 Total 11/22/2006 11:00 AM ` Parcel 032-1098-10-000 PAGE 1 OF 1 Alt. Parcel 35.31.19.456A 032 - TOWN OF SOMERSET ST. CROIX COUNTY, WISCONSIN Current X''. 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 - PLOURDE, BETTY TR BETTY TR PLOURDE 220 BLUFF DR SOMERSET WI 54025 SC = School SP = Special Property Address(es): * = Primary Districts: Type Dist # Description SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 37.000 Plat: N/A-NOT AVAILABLE SEC 35 T31 N R1 9W NW NW EXC CSM 6/1748 Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 35-31 N-1 9W te Doc # Vol/Page Type Notes: 103/12/2004 rcel History: 756419 2525/175 OTI /08/1999 595306 1393/601 2006 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Last Changed: 08/09/2005 Valuations: NO Reason Description Class Acres Land Improve 5,Total 300 State AGRICULTURAL G4 35.000 5,300 0 4,000 NO AGRICULTURAL FOREST G5M 2.000 4,000 0 Totals for 2006: General Property 37.000 9,300 0 9,300 Woodland 0.000 0 0 Totals for 2005: General Property 37.000 9,300 0 9,300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: Category Amount User Special Code Special Assessments Special Charges Delinquent Charges 00 0.00 0.00 Total - - AS BUILT SANITARY SYSTEM REPORT Form - S T C 104 OWNER TOWNSHIP SEC. T~N-Rl ~W ADDRESS .~CJy1~b^~ f ST. CROIX COUNTY, WISCONSIN 0-7 Q o',43 37 SUBDIVISION. LOT - LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of I1HR, 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM fry 1 } r' tP r ~ r CO INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used p p 9<oc k L"2rner m~ / okS-e Elevation of vertical reference point: /(O Proposed slope at site: O SEPTIC TANK: Manufacturer: ~e Liquid Capacity: 79 2 Number of rings used:J Tank manhole cover elevation: 1-7, Tank Inlet Elevation: (Tank Outlet Elevation: 9/ ?7 Number of feet from nearest Road: Front, Side 0 Rear, 0 3 oo feet .From nearest property line Front,0 Side, Rear, O O~ 8Q feet Number of feet from: well J`-d building: (Include this information of he 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, 0 Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: Width: / Length: Number of Lines: Area Built:7S-V~ Fill depth to top of pipe: l.1oll Number of feet from nearest property line: Front, O Side, Rear,Oirt. Number of feet from well: JAG cv t s Number of feet from building: (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, O Side, O Rear, 0Ft. Number of feet 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 SAFETY & BUILDINGS DIVISION INSPECTION REPORT FOR BUREAU OF PLUMBING DEPARTMENT OF INDUSTRY, LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEM Stale Plan I.D. Number: w P.O. BOX 7969 ❑ ALTERNATIVE III assigned) MADISON, WI 53707 CONVENTIONAL ❑ Mound ❑ Holding Tank ❑ In-Ground Pressure INSPECTION DATE: / ,Sd LDER: ST o PT'. E LE V. ADDRESS OF PERMIT HOLDER: WL .y 54025 CST Rt . 2 , Box 537, Somerset, REF. PT. ELEV.: RE F. . PT. NAM E OF P E GeraldRM ITPHO lourde FIFERENT BENCH MARK (Permanan[ reference point) DESCRIBE IF DIR19W FROM own Of Somerset Sanitary Permit Number: MP/MPRSW No.: NW NW, Section 35, T31N- 7 , 1 County: ByronBird, O428 Name of Plumber: 3318 St. Croix $O Jr. LOCKING COVER PROVI DED. PROVIDED: ANK' LIQUID CAPACITY': TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LAB ~ YES ~NO SEPTIC TANK/HO DING !1 v~ ,gip YES ❑NO MANUFACTURER: WELL: BUILDING: VENT TO FRESH ` ROAD: PROPERTY AIR INL T-. HIGH WATER NUMBER OF 1:1W BOO VENT DIA.: VENT MAIL.'. ALARM: FEET FROM BEDDING: C ❑ YES NO NEAREST ❑YES WARNING LABEL PR LOCKING COVER NU F ACTURER : PROVIDED. OVIDED: DOSING CHAMBER' PUMP MODEL, PUMPISIPHON MA ❑YES ❑NO ❑YES ❑NO BEDDING: LIQUID CAPACITY MANUFACTURER: PROPERTY WELL BUILDING AIRN INLET FRESH ❑ YES ONO UMP AND CONTROLS OPERATIONAL: NUMBER OF LINE FEET FROM GAL DNS PER CYCLE: ❑NO NEAREST DAMETER MATERIAL AND MARKING (DIFFERENCE BETWEEN YES LENGTH I PUMP ON AND OFF) FORCE SOIL ABSORPTION SYSTEM. Check the Soil moisture at the depth of plowln9 MAIN or excavation. (lf soil can be rolled into a wire, construction shall cease until uP Ts L QUID the soil is dry enough to continue.) INSIDE DIA DEPTH' COVER CONVENTIONAL SYSTEM: ~I No. of DISTR. PIPE SPACING MATERIAL: PIT WID~ LT-7 TRENCHES: ~ BED/TRENCH JLO 7 PROPERTY WELL: BUILD AIR INLET DIMENSIONS o R NUMBER OF LINE 1 DISTR DISTR. PIPE MATERIAL: PIPES FEET FROM H FILL DEPTH DISTR. NEE . PIPE NEAREST GRAVEL DEPT BELOW PIPES ABOVE COVER: E LEV~I T E LEV. END: I S PROVIDE A DIAGRAM OF SYSTEM MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material or ON REVERSE SIDE. SHOW ELEVA- and furrows thrown upslope: mound systems to make certain that it TIONS MEASURED. meets the criteria for medium sand. oBSERV ATION WELLS ❑YES ONO PE RMANENT MARKERS ❑NO ❑YES ❑NO SOIL COVER TEXTURE ❑YES MULCHED SEEDED . EDGES OVER TRENCH/BED DEPTH OF TOPSOIL. SODDED ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO DEPTH OV ER TRENCH/BED DEPTH CENTER. FILL DEPTH ABOVE COVER. PRESSURIZED DISTRIBUTION SYSTEM: NO OF LATERAL SPACING GRAVEL DEPTH BELOW PIPE. WIDTH: LENGTH'. TRENCHES: BED/TRENCH DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING DIMENSIONS MANIFOLD MATERIAL: F PESISTR DIA : PUMP MANIFOLD DISTR. PIPE MANIFOLD IA ELEV.: : VERTICAL LIFT CORRESPONDS TO APPROVED ELEV.: ELEV. D ELEVATION AND COVER MATERIAL: PLANS DISTRIBUTION HOLE SPACING. DRILLED CORRECTLY. YES ❑NO HOLE SIZE 7LDING INFORMATION YES 0N0 NUMBER OF PROPERTY WELL. SERVATION WELLS: LINE PERMANENT MARKERS: OB FEET FROM COMMENTS: ❑ NO ❑YES ❑NO NEAREST ~]Y Retain in county file for audit. t Sketch System on ~ TITLE Reverse Side. SIGNATU DILHR SBD 6710 (R. 01/82) SANITARY PERMIT APPLICATION COUNTY D'LH~ In accord with ILHR 83.05, Wis. Adm. Code STATESANITARYPERMIT# STATE PLAN I.D. NUMBER -Attach complete plans (to the county copy only) for the system, on paper not less than ❑ 8'/z x 11 inches in size. completing this application. PETITION FOR VARIANCE YES NO -See reverse side for instructions for PROPERTY LOCATION T N, R E (o W '/4 S 1 APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER / L!/ ,4 SUBDIVISION NAME Iok Yom! LOT NUMBER BLOCK NUMBER 0_ PROPERTY OWNER'S MAILING ADDRESS A EST LAKE OR LANDMARK CITY f PHONE NUMBER VILLAGE ' ~p )racr^S E~ G® ZIP CODE / ~ CITY, STATE CJ 3,P _ /0?? 11. TYPE OF BUILDING OR USE SERVED: OR Public (Specify)'. ~ _ ❑ Number of Bedrooms if 1 or 2 Family applicable) Ill. PURPOSE OF APPLICATION: (Check only one in #1. Check # 2,3 or 4, if app e ❑ Repair of an d. ❑ Reconnection of Existing System 1. a. X New b. ❑ Replacement c. El Septic Tank Replacement of Only an Existing System System System Date issued Permit was previously issued. Permit # irements- 2. ❑ A Sanitary has been reement to County Copy• Attach Common minimum requ xistin System inspected and soil conditions 4. ❑ The system is shared by Common Ownership Ag 3. ❑ An E g more than one owner/building. one in #1 and only one in #2) IV. TYPE OF SYSTEM: (Check only c ❑ Experimental 1 a. Conventional b. ❑ Alternative f. ❑ IGP b. El Holding J1 Pit Privy d. ❑ Vault Privy e. 11 Mound 2 a. El system- In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 11 See a e Pit 2' 1. a. See a e Bed b. El See a e Trench ABSORPTION AREA 5. SYSTEM ELEVATION 6. WATER SUPPLY: f/ private ❑ Joint Public PERCOLATION RATE 3REQUIRED . ABSORPTION (Square AREA Feet): / 4 PROPOSED (Square Feet): • / Feet (Minutes per inch): ,r Site Fiber- Exper. CAPACITY Prefab. VI. TANK in allons Total # of Manufacturer's Name Con- strutted Steel glass Plastic App. INFORMATION New xisting Gallons Tanks oncrete ❑ ❑ ❑ Tanks Tanks ❑ ❑ ❑ ❑ ❑ Se tic Tank or Holdin Tank Lift Pum Tank/Si hon Chamber laps. VII. RESPONSIBILITY STATEMENT rivate sewage system shown on the attached PI Business Phone Number: 1, the undersigned, assume responsibility for installation of the p Mp/MPRSW No.: Plumber's Signature: (No Stamps) Plumber's Name (Print): r Name o esigner: Flu er s A ress Street, City, State, Zip Code): # Z VI . SOIL TEST INFORMAT DN CST Certifie oil Tester (CST) Name phone Number: n , .~Q~ ~ 7esl CST's RESS (Street, C, , State, Zip Code) / Issuing Agent Signature (No Stamps) IX. COUNTYIDEPARTMENT USE ON Sanitary Permit Fee Groundwater ate ❑ Disapproved Surcharge Fee 114-01- Approved El Owner Given Initial Adverse Determination X. COMMENTS/REASONS FOR DISAPPROVAL: DISTRIBUTION: Original to County, One Copy To: Bureau of Plumbing, Owner, Plumber - eQn_a4oR (formerly Plb$7) (R. 03/86) INFORMATION & INSTRUCTIONS FOR COMPLET APPLICATION ING A SANITARY PERMIT TO THE APPLICANT: , I. This sanitary permit is valid for two 2. Your sanitar (2) years; Y permit may be renewed before the expiration date, and at the time of renewal a criteria in the Wisconsin Administrative Code will be applicable; 3. All revisions to this permit must be approved if there is a change in your bust b pproved by the permit issuing new any new rooms, etc.), depth of system, or tg Plans, system location, estimated wastewater flow (number of bed- ype of system; 4. Changes in ownership or plumber requires a Sanitary Permit permit may be needed submitted to the county prior to installation; Transfer/Renewal Form (SBQ 6398) to be 5• Private sewage systems must be properly maintained. The septic tank(s) _ Pumper whenever necessary, usually every 2 to 3 years; 6. If you have should be pumped b State of Wiscquestions onsin, Bureau of Pgmb n private sewage system, contact your local code administrator a lcensed g, 608-266.3815 or the To be complete and accurate this sanitary permit application must f. include: installed; Property owner's name and mailing address. Provide the legal description where the II. Type of building or use served: If public is checked, indicate t system is to be _ restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling; III. Purpose of application: Check only one in type of use (i.e. 70 unit apartment, 30 seat repair; #1. Complete #2 if permit is for tank replacement, reconnection or IV. Type of system: check all a is in conjunction with Universitypropriate of Wisconso~epending on system type. Check experimental only if project 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 number of tanks and manufacturer's name. Indicate prefab or site constructed and t for a// septic, lift/siphon chamber and holding tanks for this system. Check the total gallons to be installed, tanks received experimental product a VII. material. Complete VII. Responsibility statement: Installin IVIP, 9 Plumber is pProval to from fill in DILHR; name, license number with experimenta! approval only if etc.), address and phone number. Plumber must sign application form. Fill i a applicable; ppr prefix (e.g. VIII. Soil test information: Certified soil tester's name, certification in designer name if IX. County/Department Use Only; number, address, and phone number. X. Comment area for use by county or resaon given when application is disa rov Complete plans and specifications not smaller than 8% x pp ed. 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water streams and lakes; dosing or pumping chambers; distribution boxes; soil bsorpt on syste location of system areas,- and the location of the building served; B) horizontal and vertical elevation re eren service; C) complete specifications for pumps and controls; dose volume; elevation differencesyf'ctio replacement performance curve; pump model and um reference points; required by the county; E) soil test da a on a115 fom manufacturer; D) cross section of the soil absorpt onosystem GROUNDWATER SURCHARGE On May 4, 1984; 1983, Wisconsin Act 410 was signed into law. This legislation is more commonly known as the groundwater protection iaw. This result of over 2 years of stead neotiation change in statutes was the '.7 included the creation of surchargeg (tees) fora public eebate. The groundwater bill can effect groundwater. The surcharge took effect on July , 1 1 984. All of the water that Ground,~z Ater regulated practices which Wiscom,M's is used in your building is returned to the groundwater through your soil absorption buried system or the disposal site used by Your holding tank pumper. pyre nrionies coilectea through these s t by the Department c''aroE-s are edi ed to the groundwater fund adminis. of Natural hS ~(a :rb c These 4 gr ourtnwa.ler contamination if ~ ~ ` used for i'EOnlt0l In r t6; pr~tect ng )I mx,r:t of standa•ds. Croundti ai.., ~ +3 t_03/s6) i 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. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ell Owner of Property l~ a Location of Proper (A-) 1%. Section e5~ , TN-R 7 W Township l Mailing Address ~CX Address of SiteC , Subdivision Name .Lot Number Previous Owner of Property Total Size of Parcel u 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 a J-5. and Page Number__r3 9 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) ceAti-6y that a t 6tatement6 on th.i6 6okm cute thue to the but o6 my (ouh) knowledge; that I (we) am (axe) the owneh. (s) o6 the pnopen ty de,5 cA ibed in thi s .in6onmation 6oAm, by viAtue o6 a waAAant deed heconded in the 066ice o6 the County Reg.idten o6 Deeds as Document No. t /V ; and that I (We) pneaentty awn the pnoposed a.c to bon the .sewage dispoa s ya em (on I (we) have obtained an ea,aement, to nun w.cth the above dedcAi,bed pnopenty, bon the conatnuction o6 aaid s yatem, and the .dame has be n dut kee ded in the 066.ice o6 the County Reg.iaten o6 Veedb, ab Document No. Z SIGNATURE OV OWNER SIGNATURE OF CO-OWNER (IF APPLIC-AB-LI)- ZCF. AC% DATE SIGNED DATE SIGNED H z N a r STC - 105 r a H H SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County Z cy a t» OWNER/BUYER ROUTE/BOX NUMBE Fire Number R ~ Z I P 4 c5 .CITY/STATE PROPERTY LOCATION: N~fO it It, Section,,~'kj , T r N, R-a-W, ysl~~ , St. Croix County, Town of~ Subdivision , Lot number I Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper. What you ptit 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 y three year expiration. ° E z I/WE, the undersigned, have read the above requirements and agree x to maintain the private sewage disposal system in accordance with M 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 G DATE St. Croix County Zoning Office P.O. Box 98, Hammond, WI 54015 715-796-2239 or 715-425-8363 Sian, date and return to above address. REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS DEPARTMENT OF DIVISION INDUSTRY, PERCOLATION TESTS (115) P.O. BOX 7969 LABOR AND • MADISON, WI 53707 " HUMAN RELATIONS (ILHR 83.0911) & Chapter 145) LOCATIONy SECTION: NICIPALITY: LOT No.:BLK. NO.: SUBDIVISION NAME: OWNSHIP/MU A,l ~/4 N/R/ E (or 5~ f /V MAILING ADDRESS: COUNTY: OWNER'S BUYER'S NAME: ,5 Gr'~ / X Ga c l"C Gam' DATES OBSERVATIONS MADE USE PROFILE DESCRIPTIONS: PERCOLATION TES//TS: NO.BEDRMS.: COMMERCIALDESCRIPTION: r7lNew Replace _EE1~6 ${v Residence RATING: S= Site suitable for system U= Site unsuitable for system FC0g__Efff_I =MO N-GROUNDPRESSURESYSTEM-IN-FILL ANK: RECOMMENDD SYSTEM:loptional) U S ❑U ❑ S [$l U ❑ S Z U ,_o'/ DESIGN R T If any portion of the tested area is in the [If Pecolation Tests are NOT required nder s. ILHR 83.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS COL R, NOUMBER DEPTH N. ELEVATION DEpBSERVEDOUND EST.EHIGHESTS TO BEDROCK IOF OBSIERVED (BEET ABBRV ON BACK jEXTURE, AND DEPTH 0-/ 0 p !d a r1 Si' !v ^3.a ~`~/~•Z ^ ~/B~ „3 B- Z 7 rls - vim' ©!o-/i404 Sf1 /-0-- N s- --70~5il r B-~ 7 d 6 5 G^ $ O -sGo r~ii A66 j, % _3G Ag!C~p S. JB- B- q film 4C_ B- PERCOLATION TESTS DEPTH WATER IN HOLE DROP IN WATER LEVEL-INCHES RATE MINUTES TEST TEST TIME NUMBER IIIIIIIIIIIIIIIIIIIN AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD 3 PERINCH L3 P- (u/ W/A^ g0, P- r ~ gi 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. SYSTEM ELEVATION 3 3 E E r ch .Crj h►, _ i "V_0 O~ s- I , 3 VO 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. [ADMR E (print): TESTS WERE COMPLETED ON: ESS : / 40 CERTIFICATION NUMBER: PHONE NUMBER (optional): 6 S$ ^ 6.0 ~O u/ 7. 1 41 ;7 CST SI A URE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 10/83) -OVER - e 'N., _ 1395 r a gect; TANK C)M_Y iF- M iW i j to sca9 awn, and -erc- in !he app x; F FILED ?1AYti, U _V11 T1 9S nri T-y ureS a St } Colo ter i "s r fs Is 'i low 1 rr, e r i(, i r TO THE OWNER: T h' oil test report is the >t step in securing a sanitary permit. The county or the Department may request s in of this s i e field prior to permit seance. A comp) : set of plans for the private s- system and a Pei I L al __timust lie SL' m ' to the apf -ol e local authority in order to of 0 ! a permit. The sani n w. obtaineu -ted prior to the start of any construction. L r~ ru PLOT PLAN / PR,9JECT i' ~~~cl v^t/~ ADDRESS go /Cr11 /4 AIaJ 1/4/S ,jr R l N/R e W TOW , .~,n OU NTY ~ Gr MPRS Byron Bird Jr. 3318 DATE BEDROOM CLASS PERC COE TANK L~ IN-GRO D PRESSURE CONVENTIONAL LIFT_ MOUND_ HOLDING LIFT TANK SIZE SEPTIC TANK SIZE ODe~ HOLDING TANK SIZE DOSE TANK SIZE ABSORPTION AREA PERC RATE ___,,.;__-BED SIZE Benchmark V.R.P. Assu7:X4,17-e- tion 100, fr.t~ Location of Benchmark * H.R.P._ Scale _ e:!!~t Feet p Borehole Q Well O Perc Hole x• n/Gr,✓L Ystem Elevation 3. 9 TYPAR COVERING t 2" 12" 3 6' Q X 3' (D 3~ 3' 3' 1 Sewer Rock 18, 24' 6 " 12' Yaks 4r r a T a -1 L I", I I I 3 ~a 0 I a - ~44( 4F* 6 r0 G~7L ~