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HomeMy WebLinkAbout020-1088-30-000 Q o N o0 r 3 0 v y O 60 N cz 0. 0 Ct 0 0 N H r I I 0 h U N U N N O C Z c lL C E O a-J o ~ % 'CS U ~ x 'a CO ~4 <1 -0 N M 4-4 O ~ o W Z y I H H Z E 4-J ~ v! 0 1 N 3 M ON M F 13, z a m ^ P P,' Lr) Lr) 00 .0 00 1 o z a c 3 c~v o 1 r-4 J p' _ H r 7 -I r o 1 N H r m z ON c ~ -o S I N °1 = I A O) n3 N j\ W y ~ ill o 00 z C~ .0 U O Z m z = W r H ~O CA N z 3 ~z Z ro Hi 195 -0 i 4-J CD c ~ r O M H E D N 1 O rz: •r1 CL a C\l Lo z a) E .2 Z > ° 'I LO Cl) H H L w x ~n v • O O O = z N R oaCL CL N r ~ _ Lo Lo c'n U 00 m Z ~I a~ci o o = m co y c a M o N m fJ - v QI in co ~v cr-l +v o 0 ) N c o U c o E CD C:) U d = 72 0 or C) R N co U) C? co C 42 00 C." O N N~ .yd.• 0 Z r~ CO Z ° E O o rcli 2 Co o z 2 H U) C~ r E 4wj E d 4) m `m a CL ce a .2 ' v rw c c _1 A U a 2 ! 0 in 0 Parcel 020-1088-30-000 01/25/2007 10:20 AM PAGE 1 OF 1 Alt. Parcel 32.29.19.371 C4 020 - TOWN OF HUDSON 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 - NOLAN, MICHAEL K & SALLY J TR MICHAEL K & SALLY J TR NOLAN 473 STAGELINE RD HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ` 473 STAGELINE RD SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 3.600 Plat: N/A-NOT AVAILABLE SEC 32 T29N R19W NW NE LOT 4 CERT SURVEY Block/Condo Bldg: MAP IN VOL II PGE 366 ORD Tract(s): (Sec-Twn-Rng 401/4 1601/4) 32-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 02/18/2005 787804 2752/278 QC 07/23/1997 1187/542 WD 07/23/1997 713/380 07/23/1997 661/596 2006 SUMMARY Bill Fair Market Value: Assessed with: 161726 495,600 Valuations: Last Changed: 10/25/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.600 78,600 393,800 472,400 NO Totals for 2006: General Property 3.600 78,600 393,800 472,400 Woodland 0.000 0 0 Totals for 2005: General Property 3.600 78,600 393,800 472,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 223 Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 27.00 Special Assessments Special Charges Delinquent Charges Total 27.00 0.00 0.00 Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP ~DSV--- SEC. 3' T 2/ N-R T - f W ADDRESS k7.3 17 ,Q ST. CROIX COUNTY, WISCONSIN SUBDIVISION'~S,4"O V+ /Q LOT LOT SIZE °Z ~cllS PLAN VIEW HOMESITE SEPTIC fLUMBfN^ RT. 3 O'NEIL RD., HUDSON: WIC Q ROBERT ULBRICHT Old Distances and dimensions to meet requirements of 1-I 63 WIS. MASTER PLUMBER LIC. NO. 3307M.PO.S MINN. INSTALLER & DESIGNER LIC. NO. 60'663 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM Tn / oX ~o~• yoo ZF 'P U°oa ~ tA6~S>~l~/~v~` ~~td~ p%3oXT 5 ~y ~D 65r i o0 0 C ~/C~~/%Olr _ fT• ~ 1 ~ 1 a' 51 15 6>7 , 807r°M r 9s•s 0 o 41 If /t .53 INDICATE NORTH ARROW /L -x X is--a'c So. 'L0 7- e %0 E f BENCHMARK: Describe the vertical reference point used / d-~Q f i Elevation of vertical reference point: 100-o Proposed slope at site: /0 ~a SEPTIC TANK: Manufacturer: Liquid Capacity: /1-00 Number of rings used: a- Tank manhole cover elevation: /03, Tank Inlet Elevation: /00.0& , Tank Outlet Elevation: / 70 Number of feet from nearest Road: Front, Side,O Rear, O OvCL- ..200 feet W,-ST Q From nearest property line. Front, 0Side,0Rear, 0 d feet Number of feet from: well l00 building: 2-6 (Include this information of the above plot plan)( 2 reference dimensions to septic tank) .w A ' PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: Pump Size Elevation of inlet: Bottom o nc elevation: Pump off switch elevation: Gallons per cycle: _ Alarm Manufacturer: Alarm itch Type: Number of fe from nearest property line: Front, e, O Rear, Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM X Trench: Bed: Width: Length: < Number of Lines: Area Built: ~~Ss yd Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side, 0 Rear, O Ft.~1 d / Number of feet from well: Vim--- 3 S fr 7 ~ Number of feet from building: (Include distances on plot plan).' SEEPAGE PIT Size: Number of pits: Diameter: Liquid dep ge pit elevation: Area Built: Has nth a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: apacity: Number of rin sed: Elevation of bottom of tank: Elevation of inlet- Number of et from nearest property line: Front, i Rear, O Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: SEPT M G 0 1 ~S Inspector b ROBERT ULBRICNT Dated: Plumber on job: TER PLUMBER LIC. N0.3307 M'F'RS MINN. INSTALLE License Number: 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS P.O. BOX 796PRIVATE SEWAGE SYSTEMS DIVISION . MADISON, W 53707 a BUREAU OF PLUMBING PPCONVENTIONAL ❑ALTERNATIVE State Planl.D.N-leer ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound (If assigned) NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPEC ION DATE: Wayne Hanson 906 Lund, N. Hudson, WI _ 95 _ 7~GC BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.: CST RE0F. PT. ELEV NW NE, Section 32, T29N-R19W, Town of Hudson, Lot#4 Name of Plumber. MP/MPRSW No. County Sanitary Permit Number Robert Ulbricht 3307 St. Croix 64892 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY. TANK INLET E V.. TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER / PROVIDED: PROVIDED. ZDDI : VVENTMATL. HIGH WATER YES LIND ❑YES LINO ALARM. NUMB- OF ROAD: PROPERTY WELL: BUILDING. VENT TO FRESH IV d LINE O IA~T / e FEET FROM S LINO ❑YE S LINO NEAREST DOSING CHAMBER: MANUF CTURER BEDDING. LIQUID CAPACITY PUMP MODEL. PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER ❑YES LINO PROVIDE D PROVIDED IG LONS PER CYCLE: PUMP ANDCONTROL SOPERAnoNAL ❑YES LINO ❑YES LINO (DIFFERENCE BETWEEN FEET FROM OF PROPERTY WELL BUILDING JVENTTOFRESH LET FEET FROM LINE AIR INLET PUMP ON AND OFF) ❑YES LINO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing ENGTH DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until L FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: ` BED/TRENCH WIDTH LENGTH NO OF DISTR PIPE SPACING COVER NSIUE DIA si PITS LIQUID \ TRENC M IAL'. DIMENSIONS PIT DEPTH of~ GRAVEL DEPTH FILL DEPTH DISTR PIPE DISTR. PIPE DISTR PIPE MA TERIAL. NO R. BELOW PIPES ABOVE Cq~EH E V NLET ELEV Enyo //ff NUMBER OF F PROPERTY WELL. BUILDING. VENT TO FRESH L PI FEET FROM LINE. AIR INLET: NEAREST-i. MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- ❑YES LINO meets the criteria for medium sand. PIONS MEASURED. SOIL COVER TEXTURE PE HMAN ENT MARKERS OBSERVATION WELLS DEPTH OVER TRENCH BED DEPTH OVER TRENCH BED ❑YES LINO ❑YES LINO CENTER DEPTH OF TOPSOIL SODDED SEEDED MULCHED EDGES ❑YES LINO ❑YES LINO ❑YES LINO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH LENGTH NO.OF LATERAL SPACING GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER TRENCHES. DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL. NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING ELEV. ELEV.. CIA ELE V. PIPES . DIA.. ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED ❑YES LINO PLANS ❑YES LINO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: PROPERTY WELL: BUILDING: FNEA MBER OF LINE: FEET RE SOM ❑YES LINO ❑YES LINO Sketch System on Reri n in county file for udit. Reverse Side. Y / N ORE ^ TITLE. - DILHR SBD 6710 (R. 01/82) C~ ~wisconsin TEnT OF , APPLICATION FOR SANITARY PERMIT , DJ L H R COUNTY (PLB 67) UNIFORM SANITARY PERMIT # InOUSTgV,LgBOR6MUTqn gElgTlOnS -Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8Y2x 11 inches in size. -See reverse side for instructions for completing this application. PLEASE PRINT PROPERTY OWNER MAILING ADDRESS 6c/>f ~ dl~ /~if/So~l d Cs LU•v 1' /1/ D ' ff~~~d,^~ ~iS PROPERTY LOCATION q L,1 I T_ A~ l4 N1/4, S 3Z , T L/, N, R /1 E (or CO- Tow- LOT N MBER BLOCK NUMBER SUBDIVISION NAME NEAREST ROAD, L STATE PLAN I.D. NUMBER 71""', I TYPE OF BUILDING OR USE SERVED c3D V X 1 or 2 Family Number of Bedrooms: Public (Specify): THIS PERMIT IS FOR A: 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. j~ Seepage Bed ❑ Seepage Trench ❑ Seepage Pit ❑ Holding Tank I~ 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 Gallons Tanks Concrete Constructed Steel Fiberglass Plastic Septic Tank Capacity Z Lift Pump Tank/Siphon Chamber_ Lid Holding Tank capacity Manufacturer: jVEE/t"f' COA,) C-,-fZ ~j0AI 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 WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): tABSORPTIONAREA ROPOSED (Square Feet): /3 ~2 0 Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumb Signature: MP/MPRSW No.: phone Number: RT. 3 O'NEIL RD.; HUDSON, WIS. 54016 / 3267 Plumber'SWAtldftER PLUMBER LIC. NO. 3307 M.P.R.S. Name of Designer: MINN. INSTALLER & DESIGNER LIC. NO. 00663 COUNTY/ DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: ]Date: ❑ Disapproved d, J~~ ❑ Owner Given Initial 4C/N! ✓ C~ O 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 p J 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 installatic- 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 S T C - 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 Xylv r 11*V JAt~ Location of Property ~ /"6 Section 32- , T 27 N - R ( W Township V P SO A/ Mailing Address /70(e Ivzzu- C 5-14 wle,6 Ace. Subdivision Name 44 -33?-7e►6 Lot Number y - /Pr9~/ ~ .SyR.y o ~~'Ui S i'o -v yd/. 2 h S' 3 6 <v Previous Owner of Property Total Size of Parcel Date Parcel was Created Are all corners and lot lines identifiable? x Yes No Is this property being developed for resale (spec house) ? Yes No Volume lD and Page Number ✓ / `r, as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Warranty Deed 2. Land Contract 3. Other recordings filed with the Register of Deeds Office In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the the Certified Survey Map shall also be required. PROPFRTV OWNER CERTIFICATION I (We) ee4ti6y that a.QQ statements on this 4otm ate tAue to the best o6 my (out) knowledge; that 1 (we) am (ate) the owneAW of the ptopehty de,6etubed in this in6otmation 6otm, by viAtue o6 a wattanty deed tecotded in the 064i.ee ob the County Registet o4 Deeds as Document No. 3 S93 5 ~ 2_ ; and that I (we) ptesen ,y own the proposed site bot the sewage postesystem Ian I (we) have obtained an easement, to tun with the above des cA bed ptopetty, 4otL the co"tlcuetc on o ~ said system, and the same has been duty teeotded in the O ~ dice o4 the County Registet of Deeds, as Document No. SIGNATU OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) 5-13 - E55 DATE SIGNED DATE SIGNED H y S T C - 105 r 9 ti SEPTIC TANK MAINTENANCE AGREEMENT 0 St. Croix County d y O W N E R /-mss R ,v7► ~/I~.Qi ~N C'' ROUTE/BOX NUMBER Fire Number CITY/STATE D~~"'~ f' J~b~`T ZIP PROPERTY LOCATION:'" Section T J9 N, R / -W, Town of ffU1~~ St. Croix County, c°sM 3 3 s'7 G o Subdivision Vol. 2_ 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 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. - 00 E 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- v 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 5^t3• 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. x m ? v CD X° ii m N :E n ~~w o a•o x r:; 0 =r CD _0 C: w m 0 m 13 v~ D O m " O O CD 'J.1 a C) 0 CD 05, co CD :E CD n W-0 CD O n Cn _ 7 N n 3~ 7 CG P~r t0 Cp A O CD CD 01 0 3 n O W I CD O_ 7 > > O w p O L C w. O Cl) Z (O C `G Q w w =r :3 0 CD 0 'o N n CD ° -CD -owo~cv < CT - COo QO A CD N p D c CD 4) Cn O - n O p c (a wow CD:30) (b' a = CD Cp C s~ pQi cn C N !n CD m , (A Sb.g :3 NO N N~WCD:E _ Z a _ co O Z =r 9k) amc~D 3cCDCD a -1 ~ p to a CD CD 0 Cn N C O 0 M R1 win D) =r Cw~O QN CO o 7 > w OL (D (n =r aL ca V vi v a MC 0* CD ~ C m v 3CD_ vCD:3-M m CD N =r 0 0. (D . 0 - CD ,~.CDm (Am =t vw - S oao wow M CD Min D t c ~ r-<° v CD N 0 w w E ~ wm n c v p v)cc0.w0 m w CD - CD N 7 CL CL - C G) N O. Co w O N (A n c m CD 3 m o CD 0 C ~ U3 a O w~ 0 (D z CL 0 7 O Co c. (D Co CD "+r n ~°o. ?cvw o ';py n~3 o~tDO°3 oQm CD Cc CD N 0 z DEPARTMENT OF REPORT ON SOIL. BORINGS AND SAFETY & BD UILDINGS INDUSTRY, IVISION LABOR AND P.O. BOX 7969 HUMAN RELATIONS ■ ERCOL.ATION TESTS (115) MADISON, WI 53707 N~ (H63.09(1) & Chapter 145.045) C5,A1 331r76o G~• Z , 3 LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK. NO.: SUBDIVISION NAME: b W 1/4 3 L /T 2-9 N/ R E c or dN yc~~so ti _43,4ti61 6/1+ COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: S/ ;1&Xct~ 77 Uosd,J Lvif USE DATES OBSERVATIONS MADE New PRO ILE DESCRIPTIONS: A ION TE TS: NO. BE MS.: COMMERCIAL DESCRIPTION: (Residence 7 , ❑Replace 3 RATING: S- Site suitable for system U- Site unsuitable for system ONVENTI NAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) C„/S-S4 T ®S ❑u ©S ❑u ©s 0u ❑S ©u ❑S ©u CVO<NTC~~~ -/~E~- c~Q E csc s 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: Floodplain, indicate Floodplain elevation: ~~CI Ff. PRO ILE DESCRIPTIONS vC/ AA - /30~e 1t ► ~Q~ SBORING TOTAL PTH TO GROUNDWATER-I`Mt +&S CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTHtK ELEVATION OBSERVED S HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- f-0 9Y7yFr >~.o Fr 43W. Av.sLAv. /0.0 gogy F F1..2.3 ve./3a. SL, '131v. S1_ D,PL'S B- 100 e-.~ f 0 9~s~ Fr > o Ft / /(o Fr- ok.13cs /r/.- AV. SLR . 33 - /30. B- f.0 9y~f FT oyl~~,~/34). 5L,, i~5 '40, 51, ,33 `QN. X4. s, Y.3 B-~ A0 o~ Fr ~ Q fT /~~.5L, 43' 4A, , Sz-, A3' dw-oR.54, 6,py i 4T C,7.5 Fr. - ~~.~a • ~c , ; o w Qa. -op. SL OW "tf (V SCI- 0 90 l~Cv F fT W ve 6 sf o F;r PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER tNGWZS AFTERSWELLING INTERVAL-MIN. PER 00 1 PERIOD 2 P 3 PER INCH P-Z , 4D .rr" G~C' E i GL L /E P_ AellViD .4 1- p_ .fl U E 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. QOTToM GF Be)) C.YI54114 SOW, 517411 Z ,1E6 zlr' z y Ce /cnr- SYSTEM ELEVATION vFAj ~ 5r, Po,;urn, AT f/etl,4T~© I 1 _ - - - -r- - t--~--- } ITI T~i~il~ . -L-1-TI.- H 1, 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 the ft?.,tale- d the location of the tests are correct to the best of my knowledge and belief. NAME print): - TESTS WERE COMPLETED ON: HOMBSITE TESTI ~'i~ dt, z9-e3 ADDRESS: ~y.r~ (~"~"'t7 CERTIFICATION NUMBER: PHONE NUMBER (optional): R9. 3, 9 i 0r'~ iD - - y✓ QL U~~' P ■ y' J. T SIGNATURE: DISTRIBUTION; Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - /000 `T PLB ~7 ano PLOT CR055 - SC-cTJ O N F Ip• . S dam- Z D O rJ ~ ' /07, l w14 I `11 Sod ~ ~ 0 I 0 O izda ~a P. ~044r s~f,~ r- Rot as t, ~ x G `6 AIED HOMESITE SEPTIC PLU BING CO. RT. 3 O'NEIL RD.; HUDSON, WIS. 54016 ROBERT ULBRICHT W N CS~1 33f LIC.NO. 3307M.P.R.S. I f l T ANN. fNS1ALLER & DESIGNER LIC. NO. 00663 s Fresh Air Inlets And Observation Pipe SOIL TE 5TO-) y (3y MOMESITE TES JNG Approved Vent Cap RT.3, C'NEil. R(-) HUDSON, WIS. .'-14016 Minimum 12" Above Final Grade AA M V' U ~ Above Pipe 4" Cast Iron / y - To Final Grade Vent Pipe Marsh Hay Or Synthetic Covering min. 2" Aggregate Over Pipe Distribution - Tee L Pipe 0 0000 TES r Aggregate o Perforated Pipe Below Beneath Pipe 0 Coupling Terminating At Bottom Of System 5. 5 Fr. i REPORT crN' 561L 13ORIN&S PERCOLATION TESTS Its GJ~9►~IE c~s~ovh- Svf3D. Pao T PLAM PRoSEC-i Z. D. / yAit/s~i~/ La r '46: L DArE 1n&,,~A 30-o'93 Nw/y Altr, Sr',- ,3Z, rzf . i q s~ Ceol.f - t L60MESiTE TESTING CO. //UDSov 7```'~' RT.3, O'NEIL ROAD BOB UL1;1~1(;j,A - ~ - ir$"UUSON, WIS.-.- 5,4016 G'S7r SS- 0 yf 2- PROPOSED MoosE Mosr 6E- Z,;' rr p,~ MORE FiPOM ALL TEST ^ee.35. PRo POSE 0 WELL M VST LIE ,SQ FT O~ /`fORF FiPO~t ALG rEsT e = QAt,('/yoE firs O = ~,YiST/.t1(r !,(JELL. X = PEQC. IOCfriOlvf : f/ANP g09EQE0 o toe 5400eL owr5 r a /loeiz . F3M ~£,~ric~~ ,P£FER~:vcE- Pour ",P °G a- ~~51'£EL pi~~ s6r eN wc5 `4or gT f ~~o~s DR:U~-:~~y lyr- FT LEGE N p /EV~row o~ veyl. REF PT /00,00 p~~E ExTE.c/Df . (D Fr. /yr3ovE ~Y,PADE' ri .,i o W oOOs /7 ~r R~f~RE1~G~ j'1 NG eWw-llv 2- STEEL Pi~O{s , .13 pf. N. i9 io, PPE C'/EAR ? oB l/, ovS ~,P;vE-~~ v - X p, y 65 ~ To, v iv v 10 6j Flo 0-r PZ " X 0 96 h X o X err; ~~x Sy STEM SATE iEy ~~5 3 f'► - n~ t # yD~ X 3~ 0 ° 6A4# s4rv,~,9reD ~ /zyv SQ.~r. e ~ N ~ ~r, -