HomeMy WebLinkAbout020-1163-10-000
n v, O 9 v 0 r~
° C7 ~1
"0 3
(D -0
A (D
CD ` 1
I 3 I ~ ~ ~
N z C) Cil CD
0 (n 0 00
00 R° c N o ~l
7
m 3 0 CD 2 N cN°
d
(D o 0)
0 N O N N O p W '~Y
°
<
0 o
CJ7 C CD "O N Cfl ~ M
5 3
N O j O O
3 N
A
m cn~D ~ 4C.
N W N a
(D I 0
0 ' N O O (D 0)
z Cp Cp a
° 00 cO O 0 to
cn Cn 3 ° 17 ~I.
0
~ ~ ~ 2 rye
z O O O a °Y +y
° ~ o ~ m
n' = N ch cn 00 cn
m c 3 o v g° 0
o v N o
7
~ a
m
° - 0
CL m CD
z 3 N
° c 00 z
7 cD o
X- CL
not O 7
O N
0 CD
7 O N
'a (n
CD C
v CD
CD
W m d
z
Z CD
O N C s e0+
j 7 A z O
CL O
o
7 W " M N
CD (D 10
z
a
0 3
z o
M
3 CD
N
CD
W ~ II
o -I D
O o_
~2.3 2-
7 d O
- Q 7 T
D1 C
O 7
CD z a
1 0 0
N 0 (D
X " N
A
y
n
7 b
o rt
o n
O
3 a
m I
CSD N
O
O A
3 a
0 A
0
ti
ti
e» O c„
° * ° b
in CD
CD
Parcel 020-1163-10-000 12/14/2004 04:25 PM
PAGE 1 OF 1
Alt. Parcel 12.29.20.937-939 020 - TOWN OF HUDSON
Current IX'' ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): * = Current Owner
JOHN J & DONNA M HOFBAUER HOFBAUER, JOHN J & DONNA M
284 EDGEWOOD DR
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description " 284 EDGEWOOD DR
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 0.956 Plat: 1929-EDGEWOOD ESTATES
SEC 12 T29N R20W EDGEWOOD ESTATES LOTS Block/Condo Bldg: LOT 07
7,8,&9
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
12-29N-20W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 725/550
07/23/1997 712/309
2004 SUMMARY Bill Fair Market Value: Assessed with:
49021 227,600
Valuations: Last Changed: 10/26/2001
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 0.956 30,700 145,400 176,100 NO
Totals for 2004:
General Property 0.956 30,700 145,400 176,100
Woodland 0.000 0 0
Totals for 2003:
General Property 0.956 30,700 145,400 176,100
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 212
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-STC- 104
AS BUILT SANITARY SYSTEM REPORT
OWNER TOWNSHIP SEC. T N-R W
ADDRESS ST. CROIX COUNTY, WISCONSIN
U ZO _!/(o ~j - C7C~Q
7
SUBDIVISION LOT LOT SIZE
PLAN VIEW
Distances and dimensions to meet requirements of ILHR 83
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
~I
6 # ~ r
1
~ r
r
l
INDICATE NORTH ARROW
BENCHMARK: Describe the vertical reference point used
Elevation of vertical reference point: Proposed slope at site:
i
SEPTIC TANK: Manufacturer: Liquid Capacity:
Number of rings used: Tank manhole cover elevation:
Tank Inlet Elevation: Tank Outlet Elevation:
Number of feet from nearest Road: Front,O Side, Rear, O feet
From nearest property line Front,0 Side,O Rear, O feet
Number of feet from: well , building:
(Include this information of the above plot plan)( 2 reference dimensions to septic tank)
SEE REVERSE SIDE
a
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 ABSORPTION 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 A.
Number of feet from well:
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, O Ft.
Number of feet from well:
Number of feet from building:
Number of feet from nearest road:
Alarm Manufacturer:
Inspector:
1(
Dated: LZI' Plumber on job: License Number:
3/84:mj
DEPARTMENT OF INDUSTRY,
LABOR 30;-c nELATIONS INSPECTION REPORT FOR
P.O. 607969 PRIVATE SEWAGE SYSTEMS SAFETY & BUILDINGS
MADISON, WI 53707 DIVISION
❑ALTERNATIVE BUREAU OF PLUMBING
CONVENTIONAL
State Plan LD Number:
Ho.~iing Tank ❑ In -Ground Pressure Mound (If assigned)
` ❑
NAME OF PERMIT HOLDER . '
ADDRESS OF PERMIT HOLDER:
B & H Development 836 St. NsPECno Dqr
BENCH MARK IPermanenr reference poi )t ESCRIBEIF DIFFERENT FROM PLAN Croix St., N. Hudson, WI
SE NE, Sec.12,T29N-R20W Tom,
Name of Plumber.
of Hudson, Lot~68, Edgewood Estates RE PT. ELEV. CST REF PT ELEV
William Schumaker MP/MPRSW Na
cppnrv
6382 sannary 94 r Numbe,
SEPTIC TANK/HOLDING TANK: St • Croix 58942
MANUFACTURER
I LIQUID CAPACITY TANK INLET ELEV.:
TANK OUTLET ELEV.. WARNING LAREL LOCKING COVER
BEDDING: J , '7 y PROVIDED: PROVIDED.
VENT DIA.: VENT MgTL ✓ ❑ YES ❑ NO
- HIGHwgrEa NUMBER OF RogD: ❑YES
❑YES ❑NQ L., r' ALARM: PROPERTY ONO
FEET FROM LINE. WELL BUILDING. VENT TO FRESH
DOSING CHAMBER: OYES ONO NEAREST AIRwLET
MANUFACTURER. BEDDING'.
LIQUID CAPACITY PUMP MODEL
PUMP;SIPHON MANUFq C7 UREH
❑
YES E-11\10 WARNING LABEL LOCKING COVER
GALLONS PER CYCLE: PROVIDED PROVIDED.
(DIFFERENCE BETWEEN PUMP ANDCONTROLS OPERA, ONAL ❑YES ❑No ❑YES
PUMP ON AND OFF) NUMBER OF PROPERTY WELL ❑NO
FEET FROM NE BUILDING I VENT TO FRESH
SOIL ABSORPTION SYSTEM. Check the soil moisture at thD YEh of plowingO NO NEAREST AIR INLET
or excavation. (If soil can be rolled into a wire, construction shall cease until
the soil is dry enough to continue.) FORCE N( iFl DIAME TER MATERIAL AND MARKING
CONVENTIONAL SYSTEM: MAIN
BED/TRENCH WIDTH LENGTH NO OF
DIMENSIONS / DISTR. plpE spgcwG COVER
TRENCHES. INSIDE DIA.
} MATERIAL: PIT -PITS LIQUID
GRAVEL DEPTH
BELOW PIPES FILL ABOVDEPTH UISTH. PIP DISTR. PIPE DEPTH:
E COVER ELEV. INLET ELEV. END DISTR. PIPE MgTEgIAL.
No DISrR NUMBER OF PROPERTY PIPES FEET FROM WELL BUILDING VENT ro FRESH
I LINE:
MOUND SYSTEM: NEARES AIR INLET
Mound site plowed perpendicular to slope
and furrows thrown rpe e: Check the texture of the fill material for upsl mound systems to make certain that it PROVIDE A DIAGRAM O SYSTEM
ON REVERSE SIDE. SHOW ELEV LEVA-
❑YES ONO meets the criteria for medium sand.
SOIL COVER TEXTURE TIONS MEASURED.
PERMANENT MARKERS:
OBSERVATION WELLS
DEPTH OVER TRENCH BED DEPTH OVER TRENCH BED
CENTER DEPTH of ropsolL ❑YES ❑ NO ❑YES
EDGES SODDED ❑ NO
SEEDED
MULCHED.
PRESSURIZED DISTRIBUTION SYSTEM: OYES ONO OYES ONO ❑YES
BED/TRENCH wIDrH ONO
LENGTH: No of
TRENCHES: LATERAL SPACING. GRAVEL DEPTH BELOW PIPE.
DIMENSIONS FILL DEPTH ABOVE COVER
MANIFOLD PUMP
ELEVATION AND ELEV_ ELEV MANIFOLD DISTR. PIPE MANIFOLD MATERIAL NO DISTR
DIA.. ELEV. DISTR. PIPE
DISTRIBUTION PIPES DISTRIBUTION PIPE MATERIAL & MARKING
DIA.:
INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY
COVER MATERIAL.
VERTICAL LIFT CORRESPONDS TO APPROVED
COMMENTS: OYES ONO PLANS
PERMANENT MARKERS: ~ YES
j ~ OBSERVATION WELLS: ONE
❑YES NUMBER OF PROPERTY WELL BUILDING
❑NO ❑YES ❑NO FEET FROM LINE:
NEAREST
~AiII'
7S
Sketch System on
Reverse Side. Retain in county file for audit.
SIGNATURE.
DILHR SBD 6710 (R. 01/82) TITLE
wr%mn;m APPLICATION FOR SANITARY PERMIT
iMILH
-DEPRRTMEnTOF (PLB V7) COUNTY
inousTRV,LRBpR&HUmRnRELRTIOns UNIFORM SANITARY PERMIT #
-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
PROP RTY LOCA ION ~ . .
1/4 ,.1,i 1/4, S , T , N, R E or VIL-t~E:
TOWN OF: d"
LOT NUMBER BLOCK NUMBE SUBDIVISION NAME `
NEAREST ROAD, LAKE OR LANDMARK STATE PLAN
I.D. NUMBER
.
TYPE OF BUILDING OR USE SERVED
it 1 or 2 Family Number of Bedrooms:
❑ Public (Specify):
THIS PERMIT IS FOR A:
CX~ New System ❑ Tank Replacement
Replacement Soil Absorption System ❑ Repair
❑ Revision ❑ Privy
❑ Alternate System
❑ Reconnection ❑ Petition for Modification
IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK.
uK Seepage Bed ❑ Seepage Trench
System-In-Fill ❑ Seepage Pit ❑ Holding Tank
❑ In-Ground Pressure ❑ Vault Privy ❑ Pit Privy
❑ Existing, For Which A Previous Permit Is On File, Permit #
71 An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions, issued
Total #of Prefab. Site
Gallons Tanks Concrete Constructed Steel Fiberglass Plastic
Septic Tank Capacity l
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
Gallons Tanks Concrete Constructed Steel Fiberglass Plastic
Lift Pump/Siphon Chamber
Manufacturer:
PERCOLATION RATE ABSORPTION AREA
(Minutes per inch): REQUIRED (Square Feet : ABSORPTION AREA WATER SUPPLY:
PROPOSED (Square Feet):
SM 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): ,
Signature: P/MPRSW No.: Phone Number:
,
Plumber's Address: ( 't':.1
Name of Designer: COUNTY/DEPARTMENT USE ONLY
Signatur of Issuing Agent:
Fee: Date:
i ~ ~ ❑ Disapproved
._~.~(~--J Owner Given Initial
Reason for Disapproval: /Approved Adverse Determination
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.
API'L LCAT LON FOR SAN LTARY P1A,MIT
S C - t Ol )
7'hi.; i,pi,Jic:ation Norm is to i,c cumE>lete,! in !ull and signed by t.hc, owner(s) of tht
prupcrty buini; develupc~~.l. Any inadequ:,t~ies will only result in delays of ttt~' uertrtit
i=suau - ;Should this d('VC )pmuAit be intended fur re:;ale• by owner/contrirctor, ("spec.
<r sec:ond 101-111 ;iIWULd bW 1-r:Caiue~d Lind cuatpltted when the. propurt.y is
)_Ltl'iI C~i I lily 1.1 ! -t`w ith tl,cl <1,,trcu)p1-..iat~ d:ed r. o1-_! ink;.
Owner- ut Property ~,-V
Lucat ion :)t Property j\1C 5 , Section IZ.
------.I. Z`3 N - it ZC~ W
Towr,:,hi1) 1A O-j ni -
Ma L1.inf; A,]dress 3 Z", i t( L I k ~'•1- - - _ -
Subdivision Name )=D~ wcx~~a S-
Lot Number T
Previous Owner of Property
Total Size of Parcel f
Dates Parcel was Created - ` _ -
Are ,all currrers and lot tines identifiable? - ~-_-_~u -
Yes _
Is this property being developed for resale (spec house) ? _ Yes
No
Volume „S P►..4i'5 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 ((fie) ee4 ti 6 y that att s tatementz on .thin SoAm ahe ttAue to the but o6 my
hnow•eedge; that 1 (we) am (ale) the owneh (e) o6 the pnopefc,ty dani.bedinth,i s )
in6o4mati,on 6onm, by viAtue o6 a woA an-ty deed neeonded in the 066ice o6 ,the
County Reg-i s ten 66 Deeds as Document No. Ze-w Jz~gaj
pae s mag own -the pnopos ed psi to 6o)L 'L{te ~5 a e and that 1 we l
g ey
sxc~r► (on I ( (we) have
obtained an easement, to sun with the above duc4i.bed phupercty, bon the
corvstthue t..on o6 said 6 ys tem, and the satne has been duty ltecoAded the. 0664_c-e
o6 the Counfiy Regis-ten o6 Deeds, as Document No.
1.
SIGNATURE OF OWNER SIGNATURE OF CO-OWNER ~ ^CABLE-- - -T-
- (iF' APPLICAQLE)
DATE SIGNED
DATE SIGNED
r'
r
S IL' C - 105 .
Sl•:PT LC 'L'ANK MA I NTL•'NANCE. AGREFML.NT ~
St Cro LX Count y u
c
0WNE'R BUYFN
i
f
ROUTF/BOX NUMBEk ~3~ ~~`T C►'t~i S NO F.ik: NUIli bcr
i' IT Y / VI' A'I' I. _ III-
1'10) 1 : ' EkTY LO CATION: NE tiecLii,It N, It -i W, j
T o w I I of v1~S / St Cruih COLMLy,
5ubdivLsioI I EDCre/pUO,_~S'r'A s, Lot number
i
l1111) ropcr use and mLt iQLenknCL' of your su1,L LC Sys Cent could result in
its prematut-e'tailure to handte wastes. Proper maintcnance con- I
sists of pumpint; ouL the supt:ic tank every three years or sooner,
if needed, by it licensed :_u1>L Lc tank 1~umPi r. What you htit into
Lite system can al fuct~tile fLine Llun of Lite septic tank as a treat-
nlent stai;c: ill tike waste disposal system.
St. Croix County residents m~li_ be eligibL to recelvu a grant for
it maxtIll Lt Ill of 607., of tike cost of replacement Of a foiling system,
which was iu operation prior to July 1., 1978 St. Croix County
accet,,ted Lhls program ill Augk.kst of 1980, with the rcquirelllelit that
Owners of alt new stuuks agree to keep their systems properly
III it i. I l t a in e d
'l'ike pruperty owner agrees to submit to St. Croix County Zoning a
certification fOrill , signed by the owner and by a master plumber,
journeyman plumber, restricted plumber or a Iicensud pumper veri-
fying that (1) Like 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. 4
I/WE, the undersigned, have read the above requirements and agree
to maintain the private sewage disposal system in accordance: with t
I
the standards set forth, herein, as set by the Wisconsin Depart-
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.
SICNEll
DATE
St. C..-oix County Zoning 'Office
P.O. 'lox 9E,
tlamn►o'pd, WI 51,015
71.5-716-2239 or 715-425-8363
Sign, date and return to above address.
r m
x m
x ~
fA
O \ CD ti- CCDD Oi N T: N
N CD CD (D -Gi i `D 03 0
0 0- 3 w~ 3
c CO o coww `<w 901
3c(0~ rn'a CD -0 CA 0 CDN ma~con °o?
i0 0 (n yi Q
CD O w O C- CL 0 0
0 :E CD - -X- CD
CD 0 (D co
CD w 0 F D O CD t JLjo 3 a 0 c O C=D CD ooo P
cc N ::p -
O CD c CQ W
O» O Cp O W O CD
cu o 0 = > > = o
3 -w c C c j
3z° o Spa0
c l< 0
a~
CD m
W (D O r O O c~D j'
N ='CD -wQ 1
(D CO
D
< CD CD a" A~ G = 0
u 0
(Di Co " o D c ^
1a
o 0 n CD
pp C w o CD CD O f
lllm o• N co - 0- w O
CD v w (n c
yeti ~ow - fy z
w CD w 3 C D
m O 2 CD CD CD Z
a (D n 3 4 CD 0 _-T CD CD ? Q
CD Cn ° Ch
ca c CD O D
D Q m- 0 M
w 0- ^ ww O --r O RI
Cr (a CD =T C A)
CD 5j'
OL (a
3CD0 o ~F
c m
' CDC N D CD N 0 a' CD
C (D CO
O a CC] A) O Q Al y n
(4) o c o_- (o a 1
CD 0
0-0 :E (1) C C
w 7 w CD O CS w p 1t1
Q ao CD aa~ ac'
CA 0 C `G (0 A) S CD
CD 0 C: C) CO
Q o O CD (D ~ 3 to pn
0(0 C1 o N 71 n CD o g
L1 G 0 w -ci CD Cl') c m 7
O a ? S
CIL =r
C CD
c~i nfi ° 3' a m 0 3 m
w (n a 0 < 3
e O N
t O
OE=P .RT?,ENT OF REPORT ON SOIL BORINGS AND
IN; RY SAFETY & BUILDINGS
LABOR AND PERCOLATION TESTS (115! } DIVISION
HUMAN RELATIONS P.O. BOX 7969
(H63.09(1) & Chapter 145.045) ` / MADISON, WI 53707
l-C)CATION: SE TION. TOWNSHI
t/4me1 i z /Tzq N/Rzo E ( r) LOT NOT NO.: SUBDIVISION NAME:
hl UDScj,-l ~ r~vJc ~ esrr~rE~
COUNT-Y- UNTY: OWNER'S/ E: MAILING ADDRESS:
ST, CP-o I X B e
UsE_ Nc. 83 ~ Sr. ~v! S-T.
NO. BEDRMS.: COMMERCIAL DESCRIPTION: DATES OBSERVATIONS MADE
%
Residence J New PROFILE DESCRIPTIONS: PER 'OLATION TESTS:
A ` ❑Replace 71t Z_
`T'- So)LS' (Z:) rCz - dNAM1q
RATING: S= Site suitable for system U= Site unsuitable for system
CO
NVEN L: I MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:(optional)
~_®S oU os ®U C.s ❑u s _
If Percolation Tests are NOT required DESIGN RATE:
under s.H63.09(5)(b), indicate: M A If any of portion the tested area is the
G 3 Flood plain, indis cate Floodplain elevation:
PROFILE DESCRIPTIONS
BOf,ING TOTAL DEPTH TO GROUNDWATER INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPIIi M. ELEVATION !OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
-7 7'
z' 5r'-
rFRD-2 /O.43
'...tn
o•.z23st' z38o' r~ xB, LL or L f 3 btZo4o '.g675NNC' MS 3>rw UV N /5 C ea5 _!.w'TO~ ' Ri:G;D nr $.~.r ~T'C1,at:m~o +5~ 5• ;uoZ'~ ..o80 8+-
~,c j
0 N8i~/ 'M.v t e 5S
;
`j I! , 95 /00,7( o y
a5' F3 nv ?'ti/I TO <j
n. Lg' gl t Z,00' g.rGS w c'c u. ~,o:=,' -4 i'P /I
I B- 4- IZ• ~ fo!• 38 X10 /Jt=_ ~ ~f,
Y $-j 45 Go' 9N Meg S w~<.ol' pt:. r,~.r r4 L%
70' GN v w/GR ?.iJ' OC_!LOtJ. ~!F _
j B_ O, gD n, 4& BL L'
i,Ar-~r>,a ; _ rr r
0. C'/' i;k P,,v rAF_V 5 NoCr<-.on~5 oo'
B- '
D r-# Am
_ tcEE PERCOLATION TESTSNite.toss[- L A k-f.ovr,Er
TEST DEPTH WATER IN HOLE TEST TIME SHA P1jr' PIZ102 TU rr'I~:~~s r ATr bn/
NUMBER IPS AFTER SWELLING INTERVAL-MIN. DROP IN WATER LEVEL-INCHES RATE MINUTES
P- If 100 C 2 P RIOD 1 PERIOD 2 PER D 3 PER INCH ELEV,
P 4 r o0' Z >G
P- -
PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or istances. Describe what are the hori-
zontal and vertical elevation reference points and show their location on the lot plan. Show the surface elevation at all b rin s and the direction and percent
of land slope. E, c r 9
SYSTEM ELEVATION
f~ e~
C~ Z p
~f
!5 IT
i
' :d 7 iob. of I...
~y. _a
I ~
I i
r
/3
ks
1O ~
TN
s
6,
\119
O be
C) E h~Ot_E TEST ~0 r1 \ 1 y `
O PEr 4T1 onl v~ 4 ,z V ` 1
.p
1,0
_t MIZ)T 4,
v - -
G ~ ~ p•.
I, the undersigned, hereby c tify that the soil tt\s reported on this form were made by me in acc?~r.
iih the procedu and
Administrative Code, and that the date ,ecorded and the location of the tests are correct to1he•ti_est of my knowledge andrbelief. melt cods speafied in the Wisconsin
5 lJ
JAMS ~vScl~ ` Iv TESTS WERE COMPLETED I:
ADDRESS: t, ~J I =~rzl8;
CERTIFICATION NUMBER PHONE NUM EER(optional):
yob ~
Zi V Son,~lAlr. 5C~F5 ;r~ ",:a-,;O✓;)
CSI SIGNATURE: -
aL-NGH MA12.k~_ IS
oa f._o7 F3- E,..-e V 160.00- P,41nrTc-u P_
~
DISTRIBUTION: Original and ona copy to Local Authority, Property Owner and Soil Tester.
01I 1I; iS!:0-0,',t,)Ii 1r;. 02/,s>)
c,vFll -
1 +
} ci
V `
U
4
~`lo
1
J V is ml:, 4-1, i
SAFETY BfVISION
N0-0 TRY~h'TUF REPORT ON SOIL BORINGS AND DI
N
LABOR AND P.O. BOX 7969
HUMAN RELATIONS PERCOLATION TESTS (115) DVIS MADISON, WI 53707
(H63.09(1) & Chapter 145.045)
E-OCATR5N: SECTION: TOWNSHIP LOT NO.:BLK. NO.: SUBDIVISION NAME:
SE '14AeI4 i z /TZ_,_N/Rzo E , r, U~SGnl 8 ~~~v~/cx>~ Esr~rEs
COUNTY: 0WNUT-5/ E: MAILING ADDRESS:
ST. CR-1 I X l3 D E NG, 83 ST. Cev! ST.p 14 V W Scan,
USE
DATES OBSERVATIONS MADE
TNO... E DRMS.COMMERCIAL DESCRIPTION: PROFIL EI P1 1 1 ATION TESTS:
sidence ~ ` %New ❑Replace 5 2
C-r F ¢9 :DoIL-s m~C.Z - A,M4N
RATING: S Site suitable for system U= Site unsuitable for system
CON
VE:N I'IONAL: MOU NO: 'l~IN-GROUNcD-PRESSURE- : SYS'iEM-IN-FILLHOLDINGTANK: RECOMMENDED SYSTEM:(optional)
~ ❑U I DJ K) ff
EA c J RU I FI S ~11 /~31X31o' CGNVElJ7r w'Jgt 1~~JD
If Percolation Tests are NOT required DESIGN RATE: Ithe tested area is in the
under s,lifi."3.09(5)(I)), indicate: (J•~t. < 3 A ,
ate Floodplain elevation: 'V 7"t
PROFILE DESCRIPTIONS
H ~I ING TOTAL DFPTfi TO GROU DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMHFR DEfrlll f79. ELEVATION
_11O_BS-ERVED EST. HIGHEST TO BLDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
e) /Ztl t7l ii, 1 ' O. _ !`i_ /•!n-/'' Jr W,' +r2.~ X30, fr31^_~ > ~.4-ra' '~I
: r
cant-," ! `F drvlr.
Y
~ 1.,,sU$wi<,o.,
•Y'r,N
LB2-
c
0 0o' Rlp $nr Maw 5; Z. 80' Sn< "''I tv
.33' BL L~ 4.75' T3N CS w/Gtr
B- 11 o o, ;t > '95r LoJ~J •oo`. e.a BV Mer
,95 (or..r~- '
r-- u5' f3 N NA E--u J
r l j' L ?.u?' K,N!~ c, i/• ~ Cc~r3~ •a.0 SrJ NAZDPAr'
g Qo F
B h.o
- - _ 3! Y gN ~S ; loo' 13N M ev 5 8.4 f, u
oe-Ihort- :JtT'!
014 S r K +v
- - - ..I i t- {5 n/ l*1t:9 .~i f{t ~1 „^__C7r✓5 , UU 'l1
B
.JDTE+u r. T-q~-LAYr o,✓ k.f_c~uIQ ES CVlz lrir
PERCOLATION TESTS ~
SNAP/J, PR~U TU M<.tA~LFTrdn/
TENT DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIDO t PERIOD2 PERIOD PER INCH ELT
P f moo __~4N 2 ~G
PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or istances. Describe what are the hori-
z ontal 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. - µ.l L~,7
SYSTEM ELEVATION
S• oca p P
7i 0 v S
c
i t• _t
1
if Jv~, r P i_t C j
N✓' a.r , VrJ
13
NO UDSON } fN
0- C
50
P` , +Z
PE'QCt~r.-.RTI one r II ! i ,
y ~,JT .•1' O
r) 0?
.5
P'
l l ,
41 44
I, the undersigned, hereby c*tify that Jie soil tests reported on this form were made by me in acerd-with the procedures and mlods spec Pied in the Wisconsin
Administrative Code, and that the dat corded and the location of the tests are correct to the test of my knowledge and belief,
~ ~ la
NADIE (print):
} yo + TESTS WERE COMPLETED ON:
-;DURESS: _ `'?7 , .
CERTIFICATION NUMBER: PHONE NUMBER(optional)
CST SIGNATURE:
h"1+~r AT vVt~ ~
DISfRI3UTION. C igi T F 6 /1.7 It ty, Tt1 ~en L
na ind one copy to Local Auttlor Property Owner and Soil Tester.
UVf=ft
I_> 1: P Dj! T Y, O F REPORT ON SOIL BORINGS AND SAFETY & BLJII DINGS
INDUSTRY, DIVISION
UMA AND - S PERCOLATION TESTS (115) P.O. BOX 7969
HUMAN RELATION,, MADISON, WI 53707
(H63.09(1) & Chapter 145.045)
LOCATION: SECTION: TOWNSHIPf III LOT NO.: BLK. NO.: SUBDIVISION NAME:
5;= 1/4me/a z /TL-? N/_Rzo E( r) 1+UDSb/J F.s--Beres
COUNTY: OWNER'S/ E: MAILING ADDRESS:
~~T, G42--o I X a I-~ 1J e V~F IVY. 831- ST, Q. /K 5T.
14 u O So,,v~
_ DATES OBSERVATIONS MADE
rNO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DFE_S_CR IPTIONS: ER LATION TESTS:
xResidence A, New
J~
L J ` ❑Replace
z - N\ tA
BATING: S= Site suitable for system U= Site unsuitable for system
ONVEN n6NAI_: MOUND: IN-GR0UNDPRESSURE: SVT-E-M-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:(opIionaI
[DS ~U ~~S ®U~ UPS ❑U 9S 0U1ElS U ~~'x3~+OoNVEn►TIOrJAt_ $tflD
DESIGN Trsts are NOT required RATE:
In -
y prtion of the tested area is in the t n
ruder S.H63.09(5)(1)), indicate: (J 3 Floodplain elevation: ty y 4
- PROFILE DESCRIPTIONS
fw~
BONING IOTAt- DFpi_t TO GROUNDWATER INCITES CFIARACTER OF SOIL WITH THICKNESS, COLOR TEXTURE, AND DEP-TH-
Nl1MBER DEf'fH flsJ, ELEVATION
OBSERVED EST. HIGHESI' TO BEDROCK IF OBSERVED ISEE ABBRV. ON BACK.)
Y B I IZrz =j I _ t°i'- / ^7' 7F'.'° U ✓ W/: + r ..,'"30,
Y :I•f ?'Y1E"i1 Z.5•'
L1>l/ n~NTrrr> • `i ,?s' 1' fS 00, alb
/0.43 °J`~.G~1 ~'fn.~/!? „ .3• I /G0~ $•Cvs;c~.C)O' :~y•F~S~ 2.~'Linl!'y~gu; vd.'<.o
-2- J•4 00KILON5 OF F-0 8N MED 5 vo' Rb $n! Mom S; Z. Bo' B~/ 6~1 Ev S
+ IO F` 0133' 8L L (15 w/ 62 Co 5; voz' Z o e.y MEN S
Q- 2? 11.95 /oo, t~l 'y 9.Sr
- - 85' P,N ,/I eU s
en_.L;j' 8C. RNr:S w,/~KL ~.Ut3.' x•03' G:a F,~rJ PAir pPA~'•
Q a° IG. ,tea' / 3 3 TI a i'1e •3`3
- - Jr Y JSN •1,5 gw me•D S w~<.OI' Dr_ 80 N),D, 5 uov_r~o/.~
n, 4ol 71_ ! on' QN w/Gk h./U' /GO a..~ N f F-G PA'~t 4 /i r. C
FB
O.o/' i;t: g,./ twmy 5 fFop_'Z.0" ~ ; ~ UU' n c
BeJ /~~FiLOf~4r1 .f l'f?.N Il+t?j y
B- ,
PERCOLATION TESTS l~'T E° ruSrrti t l A r/vy 2 G~ t~ i ~E S r r/ r. E
SNAP/A/, PILtU2 Tea IMS,rAj l_>a7rbe/
TENT DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD I PERIODZ P RI PER INCH F
P-
X00' E Z > 61
Y-? Jam. J.:J ~ _ N O I.I.rai Z ~ ~ 3 _
p- 4,7- D
PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or -stances. 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 b rings and the direction and percent
of land slope. / t" ' VII _-7 rJ c '
:a
SYSTEM ELEVATIONS oo rt Vs• <
~c.c /...~d~ ~ rte: ' 't• \ ~ I\ `
S 1V rf Crl ~ i Z
n yM 1 ~ i f sz. ~ C,
A~ dL. iB 4>a Q ~ 7
T ~
II
r, X
_ \ \ I I
13 A
0 ` N
IO UOSON
_ Q
I-V0L_F_ 'T
Cj PERw~_gTrnn/
~~T f2Dn/ (J'Q''I pip
F th/ ran O
A V~
t ^r ' 1't -y f r
r ~ T
10
I, the undersigned, hereby c1 tify that tjie soil tests reported on this form were made by me in aSOxd-VV6h the procedures and me~~o~ds fed in the Wisconsin
\dministrative Code, and that the at corder) anrf.the location of the tests are correct to the-b6st of my knowledge and belief.
VAivIE (pant): o TESTS WERE COMPLETED ON:
~ ~r} 12
_
7DF,ESS CERTIFICATION NUMBER- PHONE NUMBER(optional},
' rr-• CST SIGNATURE:
/VC~4 t!)AF C_ I~ 1 l+,oe./ f'lpr A-
S \A/ ;,-r
t;-t.- G
)IS f RIBUTION: G igmal and one copy to Local Authority, Property Owner and Soil Tester.
llt rI;; 0 4;395 (F;. 0 ?/S2) - OVER
-