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HomeMy WebLinkAbout022-1093-30-001 nl'oOL!,c- 0 t7 `~1 I c y ~ 'I r ~ 3 I ~ ~ ~ co ^ (n 3= 2 N Z o co r _T; N not • n m a~ n~ 0 o 4: N CD o o~ m -4 a 3. qo- c :3 co cu D M . CO CA3 N N o I o p w O CD CD CD c 0 w -1 m o A; rn cn 3 ° H 0 o p' o d CD oA o - a n m c'o a m cn co ~c CL ° ° r1i CL 4 -4 rn m Z~ 11 N or» c ~-n vvw~, fn N C' D _ <n ° ~voo 41 o eQ ° p d V N 3 - A N y n rr w z O z m z 0 D a (D 0 m O y . o m m m 0 "kid ° N .1 Z W v ° CD m w co a a 3 z C6 --I cn ° m Z n z O CL A C z w ooh mcoN z a 3 a A °o CC N < Z I w CD A N Q n Ca. C DD CD 0 3 Z n o_ °CD x o. cn m o 0 CD f 'a N CL I °m N CL b 3 N 0 °o v 0 w (D oAI w 0 O o I 0 O0 fl ti S Form- S T C - 104 • ' ~ AS BUILT SANITARY SYSTEM REPORT OWNE/ ~Cti~ iC~. ~•t~~ TOWNSHIP SEC. 3 T _N-R (F W ADDRESS ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT LOT SIZE 7 L C PLAN VIEW Distances and dimensions to meet requirements of ILHR, 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 4 i fJ Ili f' C ~ ~ 1 INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used c_ ,c Elevation of vertical reference point: I CL's Prop1) j osed slope at site: SEPTIC TANK: Manufacturer: k 1 ~iiquid Capacity: C C z' Number of rings used: f)(Z,~~ Tank manhole cover elevation: ' Tank Inlet Elevation: Tank Outlet Elevation: 1 Number of feet from nearest Road: Front,O Side,0 Rear, O C&I feet From nearest property line : Front,0 Side,0 Rear, O feet Number of feet from: well @f 1dh!;'building: (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE ~ T ti PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: _ i Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: Alarm Switch Type: Number of feet from nearest property line: Front, O Side, O Rear, 0 Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM / I Bed: /x JJ Trench: e Width: Length: Number of Lines: Area Built: Fill depth to top of pipe: /d "r%!/ 1-v' %F Number of feet from nearest property line: Front, O Side, O Rear,O Ft. % Number of feet from well: _/PLC Z 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: Dated: Plumber on job: License Number : 10 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR LABOR & HUMAN RELATIONS SAFETY & BUILDINGS P.O. BOX 7969 . PRIVATE SEWAGE SYSTEMS DIVISION MADISON, WI 53707 BUREAU OF PLUMBING 13bCONVENTIONAL ❑ALTERNATIVE State Plan I.D.Nulber., D Holding Tank ❑ In-Ground Pressure 7] (ITassig"edI ~ Mound NAME OF PERMIT HOLDER. J ADDRESS OF PERMIT HOLDER. C Thomas Landin Rt. 2, River Falls, WI 54022 NSPECTION DATE BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN EV NE SW, Section 32, T28N-R18W, Town of Kinnickinnic, Lot#1 REF. PT. ELEV. CST REF PT ELEV Name nl Plumher MP/MPHSW N~~ C,~~„y _ Thomas Wang „a,P Pe, t N~mbet 3231 St. Croix _ 183776 SEPTIC TANK/HOLDING TANK: ____1_ MANUFACTURER. LIQUID CAPACITY TANK INL' T EL EV TANK OUTLET ELEV WARNING LABEL yJL n ROVIDED. LOCKING COVER PROVIDED PFOVIDED BEDDING: VENT DIA.. VENTMAT1 HIC;HwA ER LYES_❑NO ❑YES ❑NO A LA NUMBER OF RoaD f~ HM1i IPR.1ERTY WELL BUILDING VENTTOFRFSH YES UNO FEET FROM NE ~~yj~ AIR INLET 71 L_JYES ~~NO NEAREST--G~ DOSING CHAMBER: - R'ANUFACTURFR BEDDING LIQUID CnP ACIiV PUMPMnI)EI P(""P SIPItUti P:+n NJf WARNING LABEL O PROVIDED LOCKING COVER DYES ON PROVIDED GALLONS PER CYCLE: POMP AND CONTROLS OPERnnoNAT DYES LJNO DYES ONO (DIFFERENCE BETWEEN FN_EAR ER OF HoPEIaTV wELL BJILDIN(; ~vENrroFRESH PUMP ON AND OFF) FROM NF AIR INLET SOIL ABSORPTION SYSTEM. Check the soil moisture at th de Eh of lowing NO EST--~. o r excavation. (If soil can be rolled into a wire, construction shall cease until FORCE 't" ATF RIn1 AND MAHKIN the soil is dry enough to continue.) L MAIN CONVENTIONAL SYSTEM: WIDTH LENGTH N(, OF LIQUID BED/TRENCH DISrH rF>I sPnclr r,cF.I DIMENSIONS THENC / A RI %P sirE III, - :~~TS DEPTH / IT DEPTH C,RA V EL DEPTH FILL DEPTH ASTH PIPF DISTR PIPE DISTR. PIPE MATERIA L N G Sif3 _L ,BFLOWPIP ABOVE COVER FIVINI -II ELF NU NUMBER OF PROPERTY WELL BUILDING VENT TO FRESH tT//j Y666✓/~' / If FEET FROM LINE AIR: iJ NEAREST MOUND SYSTEM: Mound site plowed perpendicular to slope and furrows thrown upslope: Check the texture of the fill material for ~-PROVIDE A DIAGRAM OFSYSTEM mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- DYES ❑NO meets the criteria for medium sand. TIONS MEASURED. SOIL COVER TEXTURE .'t Hh1Aryf NT MARk_F RS DRSL Av;,T!I~N At I LS -l DEPTH OVER TRENCH BED DEPTH OVFH TRENCH RFU I)E PTH OF TOPS L_JYES ONO DYES ONO LEN TEH EDGES rIIL SI11111f 1) ~FEI)F D - - MuLCHEU DYES- ON DYES ❑NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM- VV EB D/TRENCH iDrH LENC,TH TNo t HE ArERALSPACINC c,HnvELiEPTHBFLOwvIPi TR ENCH ES. FILL DEPTH AHOVE COVER DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR PIPE MANIFOL DMATERIAL F DISTH DISTR PIPE DISTHIBU T ION PIPE MA TER IAL&MARK ING ELEVATION AND FLFV ELEV olA ELEV PES DIA DISTRIBUTION INF RMATION H0LESIZE HOLE SPACING DI;ILLEDCOwRECTtY I;OVCR MATFHIAI VE HTICAL LIFT CORHESPON D$ TO APPROVED PLANS COMMENTS: PERMANENT MARKERS YES C~ NO _ ❑YES ❑ NO OBSERVATION WELLS NUMBER OF PROPERTY WELL BUILDING: L YES _ [J NO LJ YES 1 _I; - NEARES - :EET FROM LINE - - - - Sketch System on Reverse Side. Retain in county file for audit. SI NA U TITLE 7 DILHR SBD 6710 (R. 01/82) ~ SANITARY PERMIT APPLICATION COUNT In accord with ILHR 83.05, Wis. Adm. Code _ LZ=__ I - = 73 STATE SANITARY yPERMIT # -Attach complete plans to the county copy ~ ( y py only) for the system, on paper not less than STATE PLAN I.D. NUMBER 8h x 11 inches in size. -See reverse side for instructions for completing this application. 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PETITION FOR VARIANCE ❑ YES ❑ NO ;~PERTY OWNER PROPERTY LOCATION e~f 1 4` '/a (-Ij%, S T '>k, N, R e E (or W PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME CITY, STATE ZIP CO?DE PHONE NUMBER VILLA E ,,NEAREST ROAD, LAKE OR LANDMARK ED M ~ fu S"ea,2 TOW OF II. TYPE OF BUILDING OR USE SERVED: ©aa Number of Bedrooms if 1 or 2 Family. OR ❑ Public (Specify): Ill. PURPOSE OF APPLICATION: (Check only one in #1. Check 2,3 or 4, if applicable) 1. a. ® New b. ❑ Replacement c. ❑ Replacement of d. E1 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. E1 Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) /V~x6- 1. a. M Seepage ed b. ❑ Seepage Trench c. ❑ Seepage Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5. SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): 3 Feet JV Private ❑ Joint ❑ Public VI. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Se tic Tank or Holding Tank ! UV e S ~ / ® ❑ ❑ ❑ ❑ ❑ Lift Pum Tank/Si hon Chamber ❑ ❑ ❑ ❑ ❑ ❑ VII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name (Print): Plum r' ignature: (No Stamps) MP/MPRSW No.: Business Phone Number: OA L14 /I Plumber's Address (Street, City, tate, Zip Code): / Nam esigner: VIII. SOIL TEST INFORMA ON Certified Soil Tester (CST) Name CST CST's ADDRESS (Street, City, tate, Zip ode As 5 Phone Number: __'31'~' Y 9 'S f I'V J IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater Date Issuing Agent Signature (No Stamps) XjApproved ❑ Owner Given Initial Surcharge Fee 9ry _ Adverse Determination J tJ o ~9j X. COMMENTS/REASONS FOR DISAPPROVAL: I i i i "~RD-6398 (formerly Plb-67) (R. 03/86) DISTRIBUTION: Orig,nal tc Ccunty, One (-;.-)py To: Bureau o. P!,rmbing, Owne.. Mu!iber ION 1INSi`RUt`.1 HUNS Wk Wt,,'` AnP! Ir'A71!r' This sanitary pe::..._ Your sanitary permit may be renewed bet, criteria in the Wisconsin Administrative Coue w ii: ue aNp ,Ll. ,U, All revisions to this permit must be approved by the permit issuing authority. A new permit may b . there is a change in your building plans, system location, estimated wastewater flow (number of be ooms, etc.), depth of system, or type of system; .hanges in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SB: ubmitted to the county prior to installation; rivate sewage systems must be properly maintained. The septic tank(s) should be pump(: pumper whenever necessary;,,us;ffy every 2.to.3 years; ping your private sewage system, co,r`. ^ a ;^'=!Tatnr n- thr, f Plumbing, 608-266-3815. sanitary permit application must inc erty owner's name and mailing address. Provide the legal d; ,.lied; of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartment, 3 _turant, etc.). Fill in number of bedrooms if building is a one or two family dwelling; ; ose of application: Check only one in #1. Complete #2 if permit is for tank replacement, reconneL.. air; of system: check all appropriate boxes depending on system tyt r-, conjunction with University of Wisconsin; sorption system information: Provide all information requested in t, k information: Fill in the capacity of every new and/or existing tar; ,ber of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Ce ,a// septic, lift/siphon chamber and holding tanks for this system. Check experimental approval or, ,:s received experimental product approval from DILHR; ,ponsibility statement: Installing plumber is to fill in name, license number with appropriate pr etc.), address and phone number. Plumber must sign application form. Fill in designer name ,licable; .;1 test information: Certified soil tester's name, certification number, address. County/Department Use Only, nment area for use by county or resaon given when application is disapprov nplete plans and specifications not smaller than 8'/2 x 11 inches must be sL: ris must include the following: A) plot plan, drawn to scale or with complete ling tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water servi -ams and lakes; dosing or pumping chambers; distribution boxes; soil absorption systems, replacem tem areas; and the location of the building served; B) horizontal and vertical elevation reference po, complete specifications for pumps and controls; c lnQ'- n- it of over 2 years of steady negotiation and public debate. The groundwater bill Ground yata4tgU44- ided the creation of surcharges (fees) for a number of regulated practices which Wisco iril effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried reasurIe ;ed in your building is returned tc the groundwater through your soil absorption am or the disposal site used by your holding tank pumper. monies collected through these surcharges are credited to the groundwater fund adminis- l by the Department of Natural Resources. These funds are used for monitoring ground- nrnundwater contamination investigations and establishment or standards. Groundwater, 1 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 inadequavies 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 /z", Location of Property 4 S'•~.(~ 14, Section 3~;- , T N - R W Township /Y ,4; C ~r 1,,, A) ~ C Mailing Address Subdivision Name Lot Number , Previous Owner of Property X". Total Size of Parcel/-,:?, 7 ~ <::-X?-f _5" Date Parcel was Created / "7Z' Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes No Volume '^1 and Page Number 114as 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. PROPERTV OWNER CERTIFICATION I (We) ee4ti6y that ate 6tatement6 on .thi.4 6onm aAe tAu.e to the but o6 my (ou,%) know.Cedge; that 1 (we) am (ane) the owner(s) o6 the ptopenty dedeh,i.bed in .th,i.,s injonma.ti,on 6o4m, by vZ tue of a wa4Aanzy deed %eco4ded in the 066ice o6 the County Regiz ten o6 Deeds a,s Document No. g f c7; and that I (we) pnebent.ey own the proposed site bon the sewage pod system (on I (we) have obtained an easement, to nun with the above descAibed pnopeAty, bon the eonsttAu.cti.on o6 said system, and the same has been duty neeonded in the 066ice o6 the County RegiA teA oA De as Document No. _3 9- q SIGNATURE OF OWNER % SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED CERTIPIPD SURVEY MAP LESLIE PAUL-SON Part of the Northeast 1/4 of the Southwest 1/4 of Section 32, Township 28 North, Range 18 West, Town of Kinnickinnic, St. Croix County, Wisconsin. W 1/+ CDR. SEC. J2, T2BN, R18 W, (coumrY suRvEYoRt MON.) U N PLATTED LANDS E1/4 co R. 1EC.32, T28N, S89' - - R t s w, fcouNTY suRvErom E/W I/4 LINE MON.) 42'39"W 5257.94' 1037.12' NOO.48'16"W 91.02' 2902.6 R(N00.2T W) N56.48'16"W 16.°0' w N RIN16•27'W) N16•I1'04"E 16.00' • RfNl6.33'E1 b } b N LOT I N 56 • 48' 56 W 109 49' O 13. 744 ACRES RfN36.27'y, b W h : 598,671 SQUARE FEET v W 0 2 N3I.32'04"E 161.08' V 9' / 918,37' I / / / 9° /J1 / Qv/ QI SCALE IN FEET I" + 200' 1 , ~1 I 0' 10' too, 200' 300 300' 7N M UNPLATTED LANDS W y IL O W 2 CURVE DATA 3 .a 1 - 2 CHORD BEARING N38. 17'48.1, ' E• CHORD 213 47 3 r ARC 254.00 W 1131.83' W m Y N CENTRAL ANGLE /2.11'29" ti 1sT TAN.BEAR 0 N 31 • 12 ' 04 "E W 2N O TAN. BEAR N 43'33 "E k: m W ~ y o Indicates 1"x24" iron pipe weighing 1.13 lbs./lin. ft. set. * Indicates 1" iron pipe found. ? 3 R Indicates previously recorded data. Q w ~ m = ,`,,,~~\11/1~N~ Q N ~G O /~/S,/ ,4rrr Dated: 16 June 1984 • ~r / rrf Vol. 5-'Page W MUR Certified Surrey Maps = S St. Croix County, Wisconsin. ...WISC. '~a :J f LAND Laurence W. Murphy, Registered Land Surveyor SHEET I OF 2 CERTIFIED SURVEY MAP LESLIE PAULSON Part of the Northeast 1/4 of the Southwest 1/4 of Section 32, Township 28 North, Range 18 West, Town of Kinnickinnic, St. Croix County, Wisconsin, Description: ' That certain parcel of lazed located in the Northeast 1/4 of the Southwest 1/4 of Section 329 Township 28 North, Range 18 West, Town of Kinnickinnic, St. Croix County, Wisconsin, more fully describe as follows; C corner of said Section 32, thence S 8 g42'59"W ' ommencing at the East 1/4 1/4 line of said Section 32) a distance 9 (assumed bearing on the East/West the parcel P be herein described; thence of continue 1 S 8to the 9°42'91 10BEGINNING, of thence 3 00 04'55"W on the West line of the Northeast 1/4 of the Southwest 1/4 of said Section 32, a distance of 564.721; thence s 89 27,4111E 918. R.O.W. of C.T.H. I'M"; 0 37' to the Westerly thence N 31 52'04,,E 165.08'; thence Northerly on acurve concave to the East, having a radius of 111.83', whose chord bears N 38017, 48-511E 253.47'; th nce leaving said R.O.W. 'ence N 16g11'0a 600' g° N56 456 W 109.49' (recorded as N 56°27'W); 5 (recorded°as N 16033'E); thence N 56048'56,,w 56.00, recorded as N 560271W); thence N 00048'56,,w 95.021 o POINT OF BEGINNING, contains 1 (recorded as N 00 27 W) to the easements of record. ng 3'744 acres, more or lees, being subject to State of Wisconsin) County of Pierce) I, Laurence W. Murphy, Registered Land Surveyor, do hereby certify that by direction of the Owner, Leslie Paulson, I have surveyed and divided the lands shown hereon in accordance with official records, Chapter 236 of Wisconsin Statutes and the Ordinances of St. Croix County; and that the above map and description are a true and correct representation thereof. 0141111#8114 , ojvs/ 100 ``LAURENCE% m W MURP. S 1 • N RIVE sr'tL$~ a l J • ~a LAND 114 ' f Dateds 17 June 1984 . Vol. Page Certified Survey Maps Laurence W. Murphy St. Croix County, Wisconsin Registered Land Surveyor SHEET 2 OF 2. H z H 9 r ST C- 105 r" • 9 H SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County z d a Z L ~QI~ OWNER/BUYER 'qA,' a 01 ROUTE/BOX NUMBER Fire Number CITY/STATE ZIP 5"4( PROPERTY LOCATION: 1.), ~4, Y- U; 14, Section T pe N, R l5 W, Town of /<AJIVICAAIA)IV St. Croix County, Subdivision Lot number l iVAP "IS Qi- Cr~/'rri~=D S~/.e~'~ s~ ~~'rS !tr .~'/~r` i~~-.s ~1-s Qa«s~~•v~ ~'39~~93 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 H three year expiration. ° E I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with H the standards set forth, herein, as set by the Wisconsin Depart- '0 ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Office within 3 days of the three year expiration date. CE SIC 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. cn x m - x ~ d w~cncnrv30 NmcO ~oIDD°~ w w o aD3 -a SSw cn r O c OC N w Err I D m voi (~D a o O a, o^ ' 7 - t UT O a 00 W O (D (C) D ' w D o ro'ca aN A o f.. a. ° o w o (D o c o w O E'r _ = O f woo < c. c c n 1 w Za O C~ < 3 EL O w cS D = w =r U) CD O O a (~D = (D w -P Cl) (D "C D Q O < o (n ca Q A L7 (D O O A c (D _O 0 n = W n 0 O a C (O ; w O O (O C C S D 0 a o•~ (o = S~ w N C Cl) m = N (D Al ryZ S S11 (n CM D T w (D (D w S (D U) CD CL (D 0 3 a (D (n c m co O~ r j W= a w? CO =Si O M (D (SD (n n = w a S a co Cl) m ~ a c g (D a C m 3 c as ? i A ~ CD (D a CD Q w o c u' w n =a o (n cQ O c f m caw o W? w Q - _ a (D 0= CL - acv,' ao Q= w S o 0 3 (n M. ((n) 0 cp = ~O cn 0 (D O c CD C a 0 = o cp a c cn 4(o a = 3 C, CD 0 ~ - w a= a m = o 3 (D cn = a o m z cn z 0 1 G NGS DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY,, P.O. BOX 7969 LABOR AND PERCOLATION TESTS (115) MADISON, WI 53707 HUMAN RELATIONS (H63.090) & Chapter 145.045) TOWNSHIP MUNICIPALITY: LOT N. BILK. N SUBDIVISION NAME: LOCATION: SECTION: n KINNICKINNIC NE '/4SW1/i4 32 /T28 N R 18 E(orW MAILING ADDRESS: COUNTY: OWNER' /BUYER'S AME: ST. CROIX THOMAS LANDIN R2 RIVER FALLS W1. 54022 DATES OBSERVATIONS MADE USE PROFILE DESCRIPTIONS: PERCOLATION ® TESTS: I I =BEDRMS: E RCIA5 - L 84 ® New ❑ Replace 5- 9 8 4 R esidence RATING: S= Site suitable for system U= Site unsuitable for system rMES TI ONAL: MOUND: IN-ROUNPRESSURE: SYSEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:loptional) ❑U ®V E1V ZS ❑U EIS EU ❑s ©U CONVENTIONAL 16X63 BED I J DESIGN RATE: J u If any portion of the tested area is in the N 0 If Percolation Tests are NOT required under s.H63.09(5)(b), indicate: CLASS 3 Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS RING EST.EHIGHESTS TO BEDROCK OF OBSERVED (SEEI ABBRV.ONOBACK jEXTURE, AND DEPTH TOTAL NUUMBER DEPTH N, DEO SERVED OUNDWAT ELEVATION BnI(1.5') an sIl(3.7') an sil w/ccp RGymot(I.4') 6.6' NONE 5.2 B- I 94.3 6.0 Bn 1 (1.5') an sit (4.5') an sil w/ccp R 9y mot( 1. 5') 2 7.51 95.6 II B B_ 3 7.2 an I ( 1.8') an s11 (4 •2') an si l w/ccp R Gy mot 11.2'1 ' 94.8 II 6. 0' B_ 4 an I( [.I') an s1l (4,8') an sl I w/ ccp R Gymot( 1.2') 7.1' 95. I 11 5. 9' i 7.2 94.3' I 5.9' Bn I f0. 7'1 an s1115.2an siI w/caP R Cy mot( 1.3 ) B- 5 B- SOIL MAP SHEET 91 PERCOLATION TESTS OTTERHOLT SIL DROP IN WATER LEVEL-INCHES RATE MINUTES TEST DEPTHS WATER IN HOLE TEST TIME PERIOD 3 PER INCH NUMBER INCHE AFTERSWELLING INTERVAL-MIN. PERIOD I PERIOD2 3/4„ 40 NONE 30 MI N. 11/4 ' P_ I 2. 3' P 2I/2" 21/16" 15 p- 2 2.8' NONE 30 MI N. 2 P- I I / 2° I I /8" 27 NONE 30 MIN. 13t4 " P_ 3 2.0' 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 92. 8 SYSTEM ELEVATION B 92.4' E SCALE 1.".' 50' _.q_.- s_.._.;_..._~ .bl BACKHOE PIT V.R.P. SPIKE IN TOPOF„. WOOD FENCE POST ` PERC. HOLE ( I ASSUMED 100, 1" IRON PIPE, AT FENCE O 'CORNER LINE FENCE 1 00' . 0 377' TN B4 B2 - - too, - 1 0 Pi I P2 p P3 - t { ~~p Ft~~O I a~ ~ ~ P~OYd ..y p~0 I B5 LN BI _ SUITABLE AREA (too X 42) 4200 SQ.,F,T, I 3 F i _ E t t S - m . r 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. TESTS WERE COMPLETED ON: NAME (print): 5 l0 - 84 LAURENCE W. MURPHY tlonal): CTION NUMBER: PHONE NUMBER(op CERTIFI A ADDRESS: 55 - 2445 715 - 425 9032 314 N 2ND ST. RIVER FALLS W1. 54022 CST SIG ATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. 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