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Parcel 040-1036-20-100 12/08/2005 10:02 AM
PAGE 1 OF 1
Alt. Parcel 8.28.19.115H 040 - TOWN OF TROY
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
SEAN B CLAUSEN O - CLAUSEN, SEAN B
439 RED BRICK RD
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 439 RED BRICK RD
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 2.256 Plat: N/A-NOT AVAILABLE
SEC 8 T28N R19W E1/2 NW1/4 LOT 1 CSM Block/Condo Bldg:
6/1653
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
08-28N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 756/611
2005 SUMMARY Bill Fair Market Value: Assessed with:
102284 235,500
Valuations: Last Changed: 07/19/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.256 51,500 175,200 226,700 NO
Totals for 2005:
General Property 2.256 51,500 175,200 226,700
Woodland 0.000 0 0
Totals for 2004:
General Property 2.256 51,500 175,200 226,700
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 111
Specials:
User Special Code Category Amount
I
I
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
I
Form- S T C - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER TOWNSHIP (1 SEC. TN-Ry_W
ADDRESS 441r__ 3 ST. CROIX COUNTY, WISCONSIN
SUBDIVISION LOT LOT SIZE
PLAN VIEW
Distances and dimensions to meet requirements of ILHR 83
1 7~\ ~ .
A k I -
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
L`
l
j f
h ,
INDICATE NORTH ARROW
BENCHMARK: Describe the vertical reference point used SI.J ern ei-
Elevation of vertical reference point: f Proposed slope at site:
SEPTIC TANK: Manufacturer: Liquid Capacity: 10-4nc7
Number of rings used: CJ Tank manhole cover elevation:
Tank Inlet Elevation: Tank Outlet Elevation:
Number of feet from nearest Road: Front ,w Side,o Rear, O 120 feet
From nearest property line Front,OSide,C~Rear,O feet
Number of feet from: well , building: jo
(Include this :information of the above plot plan)( 2 reference dimensions to septic tank)
RFF. RF.VFRSF. RTnF.
•
PUMP CHAMBER
Manufacturer: Liquid Capacity:
Pump Size
pump Model: Pump/Siphon Manufacturer:
Elevation of inlet: Bottom of tank elevation:
Gallons per cycle:
Pump off switch elevation:
Alarm Switch Type:
Alarm Manufacturer:
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: Y 2-
-1 P Area Built : 7?
Width: -t) Lenth•,~ Number of Lines:
v~ 7
Fill depth to top of pipe:
Front, O Side, Rear, Ft._
Number of feet from nearest property line:
Number of feet from well:
Number of feet from building:
(Include distances on plot plan).
SEEPAGE PIT
Number of pits: Diameter:
Size:
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
Capacity:
Manufacturer: _
Number of rings used: Elevation of bottom of tank:
Elevation of inlet:
Rear, 0Ft.
Number of feet from nearest property line: Front, O Side O
Number of feet from well:
Number of feet from building:
Number of feet from nearest road:
Alarm Manufacturer:
Inspector:
y Plumber on job:
Dated:
l 1/-0/T61,15 J 2 ~
License Number:
I
3/g4:mj
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS
LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION
P.O. BU-7969 BUREAU OF PLUMBING
MADISON, WI 53707 y~I~,
'MCONVENTIONAL ❑ALTERNATIVE State Plan I.D. Number:
,if assigned)
❑ Holding Tank ❑ In-Ground Pressure ❑ Mound
NAME OF PERMIT HOLDER: DRESS OF PERMIT HOLDER: INSPECTION DATE:
Sean Clausen AD Rt. 3, Hudson, WI 54016 e6
BEIII~ NIM (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV.:
NffE~ ~1~VNW Section 8, T28N-R19W, Town of Troy, Lot #1
Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number:
Roger Timm 88409 St, Croix 88409
SEPTIC TANK/HOLDING TANK:
MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LAB L LOCKING COVER
O PROVIDED: PROVIDED:
ZYES ❑NO DYES NO
BEDDING: VENT DIA.: VPWt MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING. VENT TO FRESH
ALARM FEET FROM LINES , AIR INLET.
DYES 9 NO DYES ❑NO NEAREST LLL~L~ ~L
DOSING CHAMBER:
MANUFACTURER: BEDDING: LIQUID CAPACITUMP AND CONTROY'. PUMP MODEL. PUMP/SIPHON MANUFACTLI WAR PRNING LASE LOCKING COVER
PROVIDED:
DYES ❑NO YES ❑NO DYES ❑NO
GALLONS PER CYCLE: PLS OPERATIONA L: NUM ER F PR WELL BUILDING. VENTTOFRESH
(DIFFERENCE BETWEEN FEE LINE AIR INLET'
PUMP ON AND OFF) DYES ❑NO INE R
SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing LENGTH JDAND MARKING
or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE
the soil is dry enough to continue.) MAIN
CONVENTIONAL SYSTEM:
WIDTH LENGTH: NO. OF DISTR. PIPE SPACING: COVER INSIDE DIA. #PITS. LIQUID
BED/TRENCH TR ENiES f MA7 ER IAL: PIT DEPTH
DIMENSIONS
GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. DIj NUMBER OF PROPERTY WELL'. BUILDING: V NT TO FRESH
BELOW PIPES I ir ABOVE -CO 7 VEN: ELLEEV IINLET. ELEV. END: PIPES: FEET FROM LINEC~ AIR INLET.
f ! R( tt:`1 9 7 Zr N 9 G Ct
MOUND SYSTEM:
Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM
and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA-
meets the criteria for medium sand. TIONS MEASURED.
DYES ❑NO
SOIL COVER TEXTURE: PERMANENT MARKERS JOBSERVATION WELLS
DYES ❑NO DYES ❑NO
JDEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL. SODDED. SEEDED MULCHED
CENTER'. EDGES:
DYES ❑NO DYES ❑NO DYES ❑NO
PRESSURIZED DISTRIBUTION SYSTEM:
WIDTH: LENGTH: NO.OF LATERAL SPACING. GRAVEL DEPTH BELOW PIPE. FILL DEPTH ABOVE COVER
BED/TRENCH TRENCHES:
DIMENSIONS
MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL. NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING
ELEVATION AND ELEV.: ELEV.: DIA.'. ELEV.'. PIPES DIA.:
DISTRIBUTION
INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY ATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED
DYES ❑NO COVER M PLANS. DYES ❑NO
COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING:
/ FEET FROM LINE Y DYES ❑NO DYES ❑NO NEAREST
°
Sketch System on u -to in county file for audit.
Reverse Side.
SI ~ TITLE Z4
DI SBD 6710 (R. 01/82)
SANITARY PERMIT APPLICATION COUN
In accord with ILHR 83.05, Wis. Adm. Code
STATE SANITARY PERMIT
-attach complete plans (to the county copy only) for the system, on paper not less than oo o
8% x 11 Inches in size. STATE PLAN I.D. NUMBER
-See reverse side for instructions for completing this application.
PETITION
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑ YES ❑ NO
PROPER OWNER PROPERTY LO A CON
'/a 4,S ~ T2Y, N, R (or)
(
PROPERTY OWNER'S M/~ILING ADDRESS tt"UMBI!W"" BLOCK NUMBER SUBDIVISION NAME
CITY, STATE ZIP CODE JPHONE NUMBER O CIT
VILLAGE : NEA~qST R~gAD,E OR L NDRKJ
TOWN c~ " jT l U 1~+ lI ~JJ
II. TYPE OF BUILDING OR USE SERVED: Q~IQ-/~ - Je
Number of Bedrooms if 1 or 2 Family rs7 OR Public (Specify):
III. PURPOSE OF APPLICATION: (Check only one in ##1. Check 2,3 or 4, if applicable)
1. a. NNew b. ❑ Replacement c. ❑ Replacement of d. ❑ Reconnection of e. ❑ Repair of an
System System Septic Tank Only an Existing System Existing System
2. ❑ A Sanitary Permit was previously issued. Permit Date Issued
3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements.
4. ❑ The System is shared by more than one owner/building. Attach Common Ownership Agreement to County Copy.
IV. TYPE OF SYSTEM: (Check only one in ##1 and only one in ##2)
1. a. conventional b. ❑ Alternative C. ❑ Experimental
2. a. ❑ System- b. ❑ Holding c. ❑ Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP
In-Fill Tank
V. ABSORPTION SYSTEM INFORMATION: (Check one)
1. a. ❑ Seepage Bed b. ~ee a e Trench c. ❑ seepage Pit
2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5. SYSTEM ELEVATION 6. WATER SUPPLY:
(Minutes pt;r inchREQUIRED (Square Feet): PROPOSED (Square Feet):
Private ❑ Joint ❑ Public
Feet
VI. TANK CAPACITY Site
in alions Total of Prefab. Fiber- Exper.
INFORMATION New Existing Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tanks Tanks structed
Septic Tank or Holding Tank ❑ ❑ ❑ ❑ ❑
Lift Pump Tank/Si hon Chamber ❑ ❑ ❑ ❑ ❑ ❑
VII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the private sewage system shown on the attached plans.
Plu er's Name (Print y Plumbs Signature: (tamp} MP/MPR Business Phone Number:
'ten ~ ~ ✓ ~'✓t 3~~=.4.~ G~.~-~_,_--% '~..`Z ~ / - ~
L-
Plumber' Address (Street, City, State, Zip Code): Name of Designer:
Vlll. SOIL TEST INFORMATION
Certified Soil Tester (CST) Name r CST
a"rtc~- / (1s"iced i
CST's ADDRESS (Street, City, State, Zip Co,~) Phone Number:
It &
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee Groundwater Date Issuing Agent Signature (No Stamps)
Approved I ❑ Owner Given Initial/ Surcharge Fee pj
Adverse Determination ~(O ~7 O(s za-1~4~
X. COMMENTS/REASONS FOR DISAPPROVAL:
kjh_ 398 (formerly Plb-67) (R. 03/86) DISTRIBUTION: Original to County, One Copy To: Bureau of Plumbing, Owner, Plumber
INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT
APPLICATION
TO THE APPLICANT:
1. This sanitary permit is valid for two (2) years;
2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new
criteria in the Wisconsin Administrative Code will be applicable;
3. All revisions to this permit must be apprq ed 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 your local code administrator or the
State of Wisconsin, Bureau of Plumbing, 608-266-3815.
To be complete and accurate this sanitary permit application must include:
1. Property owner's name and mailing address. Provide the legal description where the system is to be
installed;
Ii. Type of building or use served: I` public is checked, indicate type of use (i.e. 10 unit apartment, 30 seat
restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling;
III. Purpose of application: Check only one in #1. Complete #2 if permit is for tank replacement, reconnection or
repair;
IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project
is in conjunction with University of Wisconsin;
V. Absorption system information: Provide all information requested in #1-6;
VI. Tank information: Fill in the capacity of every new and/or existing tank, list the total gallons to be installed,
number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete
for all septic, lift/siphon chamber and holding tanks for this system. Check experimental approval only if
tanks received experimental product approval from DILHR;
VII. Responsibility statement: Installing plumber is to fill in name, license number with appropriate prefix (e.g.
MP, etc.), address and phone number. Plumber must sign application form. Fill in designer name if
applicable;
VIII. Soil test information: Certified soil tester's name, certification number, address, and phone number.
IX. County/Department Use Only;
X. Comment area for use by county or resaon given when application is disapproved.
Complete plans and specifications not smaller than 8'h 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 4410 was signed into law. This legislation is more 2
commonly known as the groundwater protection law. This change in statutes was the
result of over 2 years of steady negotiation and public debate. The groundwater bill Groundwater ~
included the creation of surcharges (fees) for a number of regulated practices which W'iscon(sin's
can effect groundwater. The surcharge took effect on July 1, 1984. All of the wafer tha' buried treasure
is used in your building is returned tco the groundwater through your soil absorption o~
system or the disposal site used by your noiding tank pumper.
The monies collected through these s jrci,arges are c redi}ed to the groundwater fund adminis-
tered by the Department of Natural R;=source~. These funcs are used for monitoring ground- t
water, groundwater contamination in ~astigations ~-,;nd establishment of standards Groundwater,
Ws worth protecting.
SSD-6308 (8.03/86)
APPLICATION FOR SANITARY PERMIT
STC-100
This application form is to be completed in full and signed by the owner(s) of the
property being developed. Any inadequacies will only result in delays of the permit
issuance. Should this development be intended for resale by owner/contractor, ("spec
house"), then a second form should be retained and completed when the property is
sold and submitted to this office with the appropriate deed recording.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Owner of Property e
Location of Property 14, Section , T ~ZS N-R~- W
Township `
Mailing Address Q H P,9 w {~~16 - _3T
Address of Site k-t bdivision Name ylp Ile
Lo, Number
Previous Owner of Property ~I el ~I f Ce
Total Size of Parcel Date Parcel was Created Ja=
Are all corners and lot lines identifiable? Yes No
Is this property being developed for resale (spec house) ? Yes t,No
Volume and Page Number fd~w
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.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
PROPFRTV OWNER CERTIFICATION
I (We) cexa6y that att .6tatement6 on this 6onm cute thue to the but o5 my (ouh)
knowledge; that I (we) am (ahe) the ownen(,s) ob the pnopenty de~schi,bed in this
.in6o4mat.ion 6oiun, by v.vrtue o6 a waAAanty de d n conded in the 066,i.ce o6 the
County Regi6teh o6 Deed 6" Document No. 41 to ; and that I (We) pnesewtey
own the pupod ed site 6oh the .6ewaq e -pob syss em (on I (we) have obtained an
ea6ement, to nun with the above descAi.bed pupehty, 6oh the con6th.ucti.on o6 .6aid
.6ybtem, and the .name ha6 a dr neconded in the 046ice o6 the County Reg.c.6ten ob
Deed6, 616 Document No.
SIGNATURE 0 0 ER SIGNATURE OF CO-OWNER (IF APPLICABLE)
DATE SIGNED DATE SIGNED
. H
z
W
H
a
STC-105 r
r
a
_ H
SEPTIC TANK MAINTENANCE AGREEMENT
0
St. Croix County z
c7
a
r~
OWNER/BUYER d 0.'15-'e'V~ H
ROUTE/BOX NUMBER Fire Number
Noisno- :CITY/STATE lfrc, ZIP
?
PROPERTY LOCATION: , 'f, Section , T I?r N, 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. H
0
I/WE, the undersigned, have read the above requirements and agree En
to maintain the private sewage disposal system in accordance with x
r-+
the standards set forth, herein, as set by the Wisconsin Depart- ro
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 Zoning Office
P.O. Box 98
Hammond, WI 54015
715-796-2239 or 715-425-8363
Sign, date and return to above address.
DT M OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
INDUSTRY, , DIVISION
LAB¢R AND PERCOLATION TESTS (115) P.O. BOX 7969
NOMAN RELATIONS \ / MADISON, W1 53707
(H63.090) & Chapter 145.045)
LOCATION: SECTION: TOWNSHIP UNICIPALITY: LOTNO.:BLK.NO.:SUBDIVISION NAME:
SEE ~/N141/ B /T2B H/R/9 E (o W TROY / C. S. M.
COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS:
ST. CROIX GLEN WIESE R 3 RIVER FALLS, W/ 54022
USE DATES OBSERVATIONS MADE
NO. BEDRMS.: COMMERCIAL DESCRIPTION: (PROFILE DESCRIPTIONS: 1PERCOLATION TESTS:
Residence 3 NA ® New ❑ Replace
NOT CONDUCTED
RATING: S= Site suitable for system U= Site unsuitable for system
CONVEcNTIONAL: MOUNcD: 1' IN-GROUNccD-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:(optional)
®S ®S DU ~V DS QS CONVENT/ONAL
If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the
under s.H63.09(5)(b), indicate: A 7 CLASS 2 Floodplain, indicate Floodplain elevation:
PROFILE DESCRIPTIONS
BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH IN, ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
/ 8.7 /00.81 NONE 78.7' Bn/ /2.0')Bns////.01)Bn/s (0.7) Bn s (5. 0')
B 2 6.91 99. 6 ' 11 2.3' an I ( 2.3'1 Bn si/ w/cep R mot ( 3. / ) On s ( 1.59
3 4.1 1 99.3' 2.9' Bn 2. 0') an sil ( 0.9') Bn si / w/ccp R mot 21)
B- 4 7.1 ' 100.2' an 1/.J')'
sil(0.811Bns and yi(0.79ans(4.3')
5 7.4' /0 I. 6' I -77. 4' Bn1.4') an s1/ 2'1 Bn s 14.61)
B- 6 4.6' 100.6' tl 2.4 8nl ( 4') an si/ //.0') Bn ;if w/ccp R mot (2.2'1
7 7.8 /00./1 ~I X7,8' Bn/(1.69Bnsil(0.8'1BnIs(0.7') Bns (4. 7')
B- B 7, 3' / 00.6' n 7. 3' On I (/.5') Bn sil (0.8') an s I (O. 79 On s ( 4. 39
9 7.51 /00.61 II X75' BnI((.l')ansil(0.7')Bn/s/0. 8'1 Ons(4.9'J
B-
SOI L MAP SHEET 74 PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD1 PERIOD2 PERIOD PERINCH
P_ No erco ation tests conducted as ackhoe pits eve.led a sandy soil condit on.
P_ B khard Sattre Conn x 3 to 10 minutes per in h Class 2
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. A 9 7. B'
SYSTEM ELEVATION B 97.6 No r E : SEP A RATE V. R. P. FOR
ir. B i F t y3i E ~4
( SU77 AREA 1,6~0 0. F
_.W._.,
1
7, 4-
Q
72"'3 { 1. __..r..... s1jrE GENERAL x .75`"' i _
n of 4 EV L ~
e ,
.
W Vvq - SU/T.,AREA
10 as 2,490 So.'FT. B9 - - -
i
4, ib
Z'T
r - ? . V. R. P. ASSUMED /0 ' t
B4 '
E
CA_
(III -
~ W JCOR. LOT / -Rg P AS UMED /O 1 - 7
1
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): TESTS WERE COMPLETED ON:
LAURENCE W. MURPH Y 12 - - 85
ADDRESS: CERTIFICATION NUMBER: PHONE NUM13ER(optional):
R/ BOX 36A RIVER FALLS, W/ $4022 55- 2443
CST SIG ATURE:
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Teste
DILHR-SBD-6395 (R. 02/82) - OVER - S
LI ST ! ; 1 4 C3R bum " w '1 is - D - 61395
~i t7
is is a residence or commercial project;
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CERTIFIED-SURVEY DAP
GLEN WIESE
Part.of the Northeast 1/4 of the Northwest 1/4 and the Southeast 1/4 of the Northwest
1/4 of Section 8, Township 28 North,_ Range 19 West, Town of Troy, St. Croix County,
Wisconsin.
O Indicates 1" x 24" iron pipe weighing 1.13 lbs./lin. ft. se
it, TOWN RoaD
66
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BEARINGS
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f Laurence W. Murphy
Registered Land Surveyor
66. 74 ' Vol. Page
42 00 4.46.74'
IV 00~•~~20rE~~AAi a S Certified Survey
County, MWisconsin
smAr r r i old' s
Tim'm JOB
SHEET NO. ° OF Z- -
Excavating CO. CALCULATED BY DATE
R Box 192, Wilson, l M7 CHECKED BY,___ Q%3:V /.I
SCALE
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iJOB
i SHEET NO. Z OF _
Excavating Co. CALCULATED BYDATE
R I, Box 192, Wilson, WI 54027
CHECKED BY D#W_
SCALE
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