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Form - S T C - 1
AS BUILT SANITARY SYSTEM REPORT
OWNER TOWNSHIP SEC. T7 N-R
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
j
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INDICATE NORTH ARROW
BENCHMARK: Describe the vertical reference point used
Elevation of vertical reference point: Proposed slope at site: j
SEPTIC TANK: Manufacturer: Liquid Capacity:
R ^ .
Number of rings used: Tank manhole cover elevation: t_1
Tank.Inlet );levation: Tank Outlet Elevation:
Number of filet from nearest Road: Front,O Side,0 Rear, O feet
From iearest property line Front, 0Side, 0Rear, 0 feet
Number of feet from: well ! building:
(Include this Information of Like id-vc' plot Plan)( 2 reference dimensions to septic tank)
I 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, Ft,
Number of feet from well:
Number of feet from building:
(Include distances on plot plan).
SOIL ABSORBTION SYSTEM
Bed: Trench:
Width: Length: Number of Lines: Area Built:
Fill depth to top of pipe:
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 di-stances on p.tot I) Late) .
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 0 been used on any of the above soil
absorbtion sytems? (Check one).
BOLDING 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, O Ft.
Number of feet from well..:
Number of feet rom building:
Number of feet from nearest road:
Alarm Manufacturer:
Inspector:
Dated: Plumber on job:
License Number:
3/84:mj
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR
LABOR & HUMAN RELATIONS SAFETY & BUILDINGS
P.G. BOX 7y69 PRIVATE SEWAGE SYSTEMS DIVISION
MADISGN, WI 53707 BUREAU OF PLUMBING
L~CONVENTIONAL DALTERNATIVE State Plan I.D. Number..
❑ Holding Tank D In-Ground Pressure ❑ Mound (Ifa-gned)
NAME OF PERMIT HOLDER
ADDRESS OF PERMIT HOLDER . INSPECTION DATE
Ryberg, Jeff R. R. 1, Box 424, Hudson, WI
BENCH MARK IPermanen[ reference point) DESCRIBE IF DIFFERENT FROM PLAN. P
SE NE, Section 33, T29N-R19W, Town of HudSon,LOt#24, Countryside Vill. REF.P EEE cST REF PT ELEV
711-17of Plumber
MP/MPHSW No. Cou my Sanitary Permit Number.
Richard Hopkins 1059 St. Croix 64846
SEPTIC TANK/HOLDING TANK: taj F
MANUFACTURER
LIQUID CAPACITY. TAN INLE ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER
PROVIDED: PROVIDED
I IX
BEDDING: VENT DIA.. VENTMAT~. HIGH WATER w ! if Li ~f YES ENO DYES ENO
ALAM H NUMBER OF J ROAD: PROPERTY WELL'. BUILDING: VENT TO FRESH
YES DNO D FEET FROM uNEy~., t AIRUyLEJri
YES ENO NEAREST
i
DOSING CHAMBER:
MANUFACTURER BEDDING. LIOUID CAPACITY PUMP MODEL P
UMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER
DYES ENO PROVIDED PROVIDED
GALLONS PER CYCLE: PUMP ANDCONrROLSOPERATONAL DYES ENO DYES ENO
(DIFFERENCE BETWEEN FEET FROM OF PR OPERrv WELL BUILDING IVENTT Es
E
FEET FROM "E AIR INLET
PUMP ON AND OFF) DYES ENO NEAREST
SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing LENC,TH JDIAMETEH MATERIAL AND 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
BED/TRENCH DISTR PIPEfPAC Nc, COVER INSIDE CIA zPlrs
/
Ml+TERIA L: LIQUID
~ rRENCHes V a
DIMENSIONS 4,
J PIT DEPTH
GRAVEL DEPTH
d
FILL DEPTH DISTR. PIFF DISTR. PIPE DISTR. PIPE MATERIAL: NO. D R. NUMBER OF
BE LOW PIPES ABOVE COYER ELty~.JNLE T ELEV. END (i PIPES PROPERTY WELL. BUILDING. VENT TO FRESH
~ ~ ~ ~ G~ [I t ' FEET FROM ,LINE: AIR INLET
L _ NEAREST-►
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 ENO meets the criteria for medium sand. TIONS MEASURED.
SOIL COVER TEXTURE
PERMANENT MARKERS. OBSERVATION WELLS
DEPTH OVER TRENCH BED DEPTH OVER TRENCH BED DYES ENO EYES NO CENTER DEPTH OF TOPSOIL SODDED SEEDED MULCHED
EDGES
DYES ENO DYES ENO DYES ENO
PRESSURIZED DISTRIBUTION SYSTEM:
BED/TRENCH WIDTH LENGTH NO. OF LATERAL SPACING GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER
DIMENSIONS TRENCHES
MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE pIS TRIBUTION PIPE MATL RIAL & MARKING
ELEVATION AND ELEV ELEV CIA ELEV. PIPES DIA
DISTRIBUTION
INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL
VERTICAL LIFT CORR ESPON D$ TO APPROVED
PLANS
DYES NO DYES ENO
COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS:
NUMBER OF PROPERTY WELL BUILDING
LINE'
DYES ENO DYES ENO FEET FROM NEAREST
Sketch System on
Reverse Side. Retain in county file for audit.
SIGNATURE. TITLE.
DILHR SBD 6710 (R. 01/82)
Wisconsin APPLICATION FOR SANITARY PERMIT
~
®ILHR 11~
(PLB 67) UUNTY
OEPRRTMEnT OF
UNIFORM SANITARY PERMIT #
~ InOUSTRV,LRBOR 6HUmgn RELRTIOnS ~ V,814~
-Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8'/~x 11 inches in size.
-See reverse side for instructions for completing this application. PLEASE PRINT
PROPERTY W . ER MAILI ADDRESS
J~rj t 4~~_ ~ " e- r e- N b e
PRO ERTY &1 LOATION
L 1/4 /4,S3j,T.* ,N,R E: C
1 E (orTOWN OF:
LOT NUMBER BLOCK NUMBER S~BDIVISI N NAME. NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER
,7 14n r-
TYPE OF BUILDING OR USE SERVED
1 or 2 Family Number of Bedrooms. ❑ Public (Specify): v' 1\, l0A)A I S L' P iry THIS PERMIT IS FOR A: `•,,n,!Y-0
New System ❑ Ta k Replacement ❑ Repair
Replacement Soil Absorption System ❑ Revision ❑ Privy
❑ Alternate System ❑ Reconnection ❑ Petition for Modification
IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK.
Seepage Bed ❑ Seepage Trench ❑ Seepage Pit ❑ Holding Tank
System-In-Fill ❑ In-Ground Pressure ❑ Vault Privy ❑ Pit Privy
❑ Existing, For Which A Previous Permit Is On File, Permit # issued -
El An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions.
Total # of Prefab. Site Steel Fiberglass Plastic
Gallons Tanks Concrete Constructed
Septic Tank Capacity
Lift Pump Tank/Siphon Chamber
Holding Tank capacity
17-
Manufacturer: C- c_ et 7e
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):
/ G CC1-' L`
Private El Joint ❑ Public
I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans.
Name f Plumber (Print): Signata~e: glfPyMPRSW No.: Phone Number:
Plumber) Address: Name"f Designer:
COUNTY/ DEPARTMENT USE ONLY
Signature of Issuing Agent: Fee: I Date: ❑ Disapproved
f' ❑ Owner Given Initial
1/, J~- -r LVApproved Adverse Determination
Reason for Disapproval:
Alternate course(s) of Action Available:
DILHR-SBD-6398 (R. 5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing, Owner, Plumber
INSTRUCTIONS FOR COMPLETING THIS PERMIT APPLICATION, PLB 67 - SBD 6398
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.
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/contractQv,("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
Location of Property Section J , T N - R 9 W
Township bL~ r o Ill t~5 O n
Mailing Address U e-
7 a
1 I L", 4 S
Subdivision Name ~OL,Lr\ <j
Lot Number j
Previous Owner of Property /-KWAl C/~
Total Size of Parcel C-~-
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 and Page Number 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.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
PROPERTY OWNER CERTIFICATION
I (we) eenti6 y that a.P Q, 6,tatement6 on this 6wtm ahe tAue to the beet o6 my (om )
hnow2edge; Aa.t I (we) am (ante) the owne.,t (6) o6 the p/topeAty dmni.bed in this
in6onmatLon i6o4m, by v-ihtue o6 a wcvutant_y deed ~teconded in the 066ice.06 the
County Regti6.teA o6 Deeds ass Doeumemt No. ; and that I (we)
p4umffy oun the p4opo6ed 6ii e 604 the 6ewage tt,6po6 6y6-tem (on I (we) have
obtained an. easement, to nun with the above dmotibed pnopeAty, bon the
c0n5.tLUCt or 06 6cud 6y6-tem, and the Game hay been duly h.econded in .the 066.tce
o6 the County Regi.6 ten o6 Deeds, a,6 Document No. ) .
SIGNATURE (F OW R SIGNATURE OF CO-OWNER (IF APPLICABLE)
DATE SIGNED DATE SIGNED
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it III axiIII it n) 0f 0U% 0I the CCi st of r(-' l)Lacc' III 00t ul a Ial It l; syriI uIII
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DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
INDUSTRY, DIVISION
LABOR AND` PERCOLATION TESTS (115) P.O. BOX 7969
HUMAN RELATIONS MADISON, WI 53707
(H63.090) & Chapter 145.045)
LOCATION: ' SECTION:: p OWNSHIP/ NICIPALITY: LOT NO.: BILK. NO.: SUBDIVISION NAME:
S E 1/40/a / 1 N/11) HE( r) W ~kcZ on u f11 r de ' /
V i I ack
COUNTY: OWNER'S/BUYER'S NAME: MAILING ADDRESS:
Cry"t x- r
USE
NO. BEDRMS.: rOMMERILINL DESCRIPTION: DATES OBSERVATIONS MADE
<3 i1 'q PROFILE DE CRIPTIONS: PERGOLA ION TESTS:
esidence
New ❑Replace
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENTIONAL: O ND: IN-GRO ND PRESSURE: SYSTEM-I N- ILL HOLDING T NK: RECOMMENDED SYSTEM:(option
SS UU S ❑U ❑S U ❑S U cmv o arn« e
If Percolation Tests are NOT required DESIGN RATE:
If any portion the tested area is the
under s.H63.09(5)(b), indicate: 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 ES T• HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
B-
,91 fC~SOrl
i
B I I ►o3.y5` hacn I I,k3; 6n ; 33+ ell Ks
• Q1 6A S . 33' + (3n S U' Y . J 5~
B- X9,'76' ~n g ASP 4130 SLQl~r- , Y*S) ~.o~'8r+sw/~~
B 7 ~ ~S+ I UPS 3.~ 3' far) S hr. j . I*7' y:*-S) 3,0'
B- ~ ~ ~ I h-{ brr,~~,n
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD t PERIOD 2 PERIOD 3 PER INCH
P-
P- Ma
_j r
G „ CSR Y~~
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 d r3
41
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yp , s''9
132
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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): r~ TESTS WERE COMPLETED ON:
ADDRESS:C~ 1
CERTIFICATION NUMBER: PHONE NUMBER(optional):
1
-32
CST S WR
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. /
i
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FRESH All' INLETS AND OBSERVATION 111VE
Ct;nSS SECTION
_J.---- ..1 Approves] Vent Cap
Minimum 12" Above;
~ Final M-07
I
" Above Pipe! - Vent Pipe
To Final Graclc--
Marsh flay Or Synthetic Cover°i it
_ -.-f _ -
Min. 2" Aggr_cy';s I
Over Pipe
Dis Li: i.bution~ 1 1 1 Tee
Pipe
Aggregate Perforated Pipe Below
9~, 5 Beneath Pipe --------Coupling Terminating At
r Botl.om nf. System
• CbMMERCIAL TESTING LABORATORY, INC.
514 Main Street, P.O. Box 526
Colfax, Wisconsin 54730 Cj CA
715-962-3121
800 - 962 - 5227
0
C. LRDIX CUUNTY REPORT DATE: 2/21/4?
THOUSE ~,.,rr r.rn >o, r.
I!.IDSCIN WT 5401'.
?zU-~ //S~- ~v-c~v
-33,2?.
1. / d
(Jeffrey Ryber~3 I~
IUN 625 Country:q to
XTOR 3 M # Jenk i n-;
OLRCE OF SAMPLE'# Kitch,
4OLIFORM*+ 0 /10C
4TERPRETATION1 Dacte,-.
6 p:.
Above
LS 'I'L HNICIAN Pam Ge,.
OF.,,ADEPEN,)
J` 9m
O p
V y
Z O
Q SA leans "LEG& TH AS` Dr-tectar Le Le,,,'
PROFESSIONAL LABORATORY SERVICES SINCE 1952
l
y
ST. CROIX COUNTY ZONING OFFICE
u,1 St. Croix County Courthouse
911 4th Street
Hudson, WI 54016
Telephone - (715)386-4680
The St. Croix County Zoning Office offers the service of septic
and water inspections to Lending Institutions, Realty Firms, and
private individuals.
Completion of this form is essential so that the property can be
located.
Please provide the following information, enclose appropriate
fee made payable to St. Croix County Zoning Office, and mail,
along with form to the above address. Testing will be done as
soon as possible after fee and form are received.
WATER TESTING----------------------------FEE: $ 25.00 C~
(For nitrates and coliform bacteria)
WATER TESTING FEE: $127.00
(For VOC'S) J -
SEPTIC SYSTEM INSPECTION-----------------FEE: $25.00
(Determines if system is properly functioning at time of
inspection) C J
Property owner's name IL ;1 ill, , 2,;,Property owner's address C~SCC ~~Ctrd Legal Description 1/4 of the 1/4 of ~ection , T TN
-R C
Town off ot Number =Subdivision Name('~.r jjtZ'icc% V I lcl~
FIRE NUMBER LOCK BOX NUMBER
Color of house Realty sign by house?laIf so, list firm:
PLEASE INCLUDE, IF AT ALL'POSS BL ,1A MAP,i.e,COPY OF PLAT BOOK,
WITH LOCATION SHOWN, AND A COPY OF HE LISTING SHEET.
Testing of residential water requires a sample that is fresh. If
the home is vacant, and has been so for some time, the water line
must be purged by running the water for several hours before the
test can be conducted.
WINTER TESTING: Many times water lines are turned off, or sill
cocks are turned off, making access to the home necessary. If
this is the case, please make proper arrangements rw th this
office to ensure time when entry may be gained. yvw
Firm or individual requesting services.~~~-t
Telephone Number%
REPORT TO BE SENT TO: L
2) C - L. C V L _ c
Closing date
Signature
i
COMMERCIAL TESTING LABORATORY, INC.
514 Main Street, P.O. Box 526
Colfax, Wisconsin 54730
115-962-3121
800 - 962 - 5227
C2:
CROIX COUNd; i ;iEr ORT DATE. 2i 0 U -
oNtTHOUSL PATF P.FI-FTVFr!!
ON, WI
-OCATION i
OLLECTOR2
`OLIF
_(PRETATION't Bacter
_ 6
W
Above
:1ifo-rm bacteria.'IUO
OF.NDEPENOEH
(iy l
V F
D
r
PROFESSIONAL LABORATORY SERVICES SINCE 1952
i~
q~ ST. CROIX COUNTY ZONING OFFICE
St. Croix County Courthouse
911 4th Street
a7 %ff Hudson, WI 54016
re i Telephone - (715)386-4680
The S r Croix County ,Zoning Office offers the service of septic
and water inspections to Lending Institutions, Realty Firms, and
private. individuals.
Completion of this form is essential so that the property can be
located.
Please provide the following information, enclose appropriate
fee made payable to St. Croix County Zoning Office, and mail,
along with form to the above address. Testing will be done as
soon as possible after fee and form are received.
WATER TESTING----------------------------FEE: $ 25.00
(For nitrates and coliform bacteria)
WATER TESTING FEE: $127.00
(For VOC'S)
SEPTIC SYSTEM INSPECTION-----------------FEE: $25.00
(Determines if system is properly functioning at time of
inspection) ,
Property owner's name
_~-~4
61
Property owner's address ` f 'LC I's (ctt. C ~6,
Legal Description 1/4 of the 1/4 of ection
Town of 4 i d., J1 Lot Number Subdivision NameLr'r i:l
FIRE NUMBER LOCK BOX NUMBER
Color of house Realty sign by house?? ;If so, list firm:
PLEASE INCLUDE, IF AT ALL POSS BL , A MAP,i.e,COPY OF PLAT BOOK,
WITH LOCATION SHOWN, AND A COPY OF HE LISTING SHEET.
Testing of residential water requires a sample that is fresh. If
the home is vacant, and has been so for some time, the water line
must be purged by running the water for several hours before the
test can be conducted.
WINTER TESTING: Many times water lines are turned off, or sill
cocks are turned off, making access to the home necessary. If
this is the case, please make proper arrangements w'th this
office to ensure time when entry may be gained.
ryvvV
Firm or individual requesting services:
L'L~ ( 1 d l~t~ /`O zl~;
Telephone Number
REPORT TO BE SENT T0: (/~d C -L j
(fY c-L
Closing date - >
Signature
z
ST. CROIX COUNTY
s h' WISCONSIN
tit ZONING OFFICE
v " rkJ ST. CROIX COUNTY COURTHOUSE
911 FOURTH STREET • HUDSON, WI 54016
(715) 386-4680
Feb. 4, 1991
Doreen Protz
First Nat'l Bank of Hudson
307 2nd St.
Hudson, WI 54016
Dear Ms. Protz:
An inspection of the septic system on the property
of Jeffrey S. Ryberg, 625 Country side Lane, Hudson, WI was
conducted on Feb. 4, 1991. At the same time a water sample was
obtained for testing. The results of that testing will be sent
to you as soon as we receive them back from the laboratory.
At the time of inspection, the sanitary system appeared to be
functioning properly. The inspection of this sewage disposal
system was based upon a surface inspection of said system, and
did not involve any excavating or chemical analysis.
Accordingly, there is the possibility of hidden defects in the
system not discoverable by this inspection. This does not in
any way warrant or guarantee the continued proper functioning or
operations of this system. It is recommended that the system
should be pumped once every three years. Therefore, the
prolonged life of this system is totally dependent upon proper
maintenance of the system.
Should you have any questions, feel free to contact me at this
office.
Sincerely,
~r
Mary J. Jenkins
Assistant Zoning Administrator
cj