HomeMy WebLinkAbout032-1086-50-000
• o d f c d 0 d
c 3 0
m p W i~
m (D C)
(D o c
(D w m
w
c N O N C4
hi O N N O -4
O N
(D O O N CD
CD_ Z a CD 0 CD o
cn 00
N a O N M CD _ j U7 ^t
00 :3 C7 CD m o co o o
O 0 o 3 00 ,~.t.
7 N O C
N C co
fD
CD (D CL a w
N -4
T C s
C
u Q N „a
CD N O fD -I "Aftw
w A
N
O O OD 00 O O
On (A ~ C
6
CD ~
O O O su
o
a 13 W (31 D
ItT m v v A o
O W 5R N N N (r
O O O) m ul
7 fD = (D CQ ~w7
N
N 3 D1
(0
m
C N
z z o
Zco z
0 D a !r
m O !~1
O CD N •
CD d N
c m CD
w a
z
O ~ 9 .p z CD
c ~j -
z o
w a O
O
O I Z
w N
~ W
a N Z
0 3 z ;7
O m c0
N Z A
w ~
a
v CL
O ~ T
3 v_ c
Z d
O O
CD
, ~ fA
0.
O
7
5
N ~
O
00 q,
Ln v
w
A .w
3
N
I N C5
V
A
O lv
:3 b
CD
v
En O
o CD -0
0
0 (a 0 3 9 n d
c
y
(D m in (D
CD
v m (D ^
III
p
0$ o 0 vi o z C) -.4 C- CD
v+ m ' o w WW `C •
S B. 3 O (D O w 3 N F~
C`t CD B.
z a :z (A 0 (D y O
O
co ' co 00
10 CD A 0 \ 1
W 0.. m 0 N
O p 7 (D 0 o0 O
p
0 (D
0 C O 0 cr O l< CD
3 v, ' CD 0
to
8 o
p m (D
v _ = a
I cn~D (o I
C7 C11 Cn ( CD (C1 CD y G v
O T CD co
~ N U) 'Z CD O CO A CD
H. ~ ft N a s 0 000 000 O I N 0 G !r
O H. rn cn 3 c
~:s rt CD
O
Z O v, C o W D < Z
(D a 0 N to in D
m ~ o v ~ o
VNi 0 CO K N N li
H I 0 ~ _ ~
H
czn a d w
N
H a 3 0)
t9 r Z
N Z co z p
d O D a
LFI
y
I U, CD
W (D m N
n (a I O W LTI c N~
CL
\ -
3
td ~ W
q I LT1 Z CD
Z
O V o y c z
rh
z 75,
N 1 v A
~a
Q o rt o
(
D W Z N
ti 0
m CD
co ~ a 3 Z ZJ
rt W 0 _
-
0 m
tA y Z A
W
CL
a ~
23 0
=3 -n
3
o o a
` m m
.~1 0
I ~ I
CD
A
03
Ln 4
n N
N
y O
O
V
O
0 cH
_ O
CD en O w
o CD c b
o i
Form- S T C - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER Cfh TOWNSHIP ~L3A'7 e11!5-,e f SEC. ,30~ T ~~Z_N-R4;/ W
ADDRESS` ST. CROIX COUNTY, WISCONSIN
SUBDIVISION LOT f LOT SIZE
PLAN VIEW
Distances and dimensions to meet regriirements of lli{% 83
SHOW EVERYTHING WITHIN L100 FEEL OF SYSTEM
n
a~
5'
INDICATE NORTH ARROW
"HMARK: Describe the vertical reference point used , /H? Ci'i/t ~d5
Elevation of vertical reference point: /491) Proposed slope at site: 3
SEPTIC TANK: Manufacturer: L~r ~S Liquid Capacity: G
Number of rings used: - Tank manhole cover elevation: n
Tank Inlet Elevation: i
Tank Outlet Elevation:
Number of feet from nearest Road: Front,O Side, Rear, O 3 06 / feet
feet
From nearest property line Front10 Side,0 Rear, O J
Number of feet from: well building: L41
(Include this information of the above plot plan)( 2 reference dimensions to septic tank)
SEE REVERSE SIDE
v ~
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, 0 Ft.
Number of feet from well:
Number of feet from building:
(Include distances on plot plan).
SOIL ABSORPTION SYSTEM
Bed: Trench:
1
Width: / Lenth: Number of Lines: Area Built:_
i
Fill depth to top of pipe:;
Number of feet from nearest property line: Front, !O Side, O Rear, Ft.
Number of feet from well: j~5c}
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: 3/84:mj
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS
LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION
P.O. BOX'7969 BUREAU OF PLUMBING
MAD( O,QN, "b 53707
121tONVENTIONAL ❑ALTERNATIVE state Plan l.D.N-be,:
(If assigned)
Holding Tank ❑ In-Ground Pressure ❑ Mound
NAME OF PERMIT HOLDER. JADDRESS OF PERMIT HOLDER' INSPECTION DATE
Le Roy Jansen R. R. 2, Somerset, WI 54025 'VJ 0130
BENCH MARK (Permanent reference Pont) DESCRIBE IF DIFFERENT FROM PLAN REF. PT. ELEV.: ICST1111 PT. ELEV.
NE NE, Section 32, T31N-R19W, Town of Somerset
Name of Plumber- ~MP/MPHSIVV N<t CSaNumberByron Bird, Jr. 318 St. Croix 75009
SEPTIC TANK/HOLDING TANK:
MANUFACTURER / LIQUID CAPACITY TANK INLET FLLVi TANK OUTLET ELEV IWARNING LABEL LOCKING COVER
JP VI ED. PROVIDED.
f
G~ C YES O ❑YES O
BEDDING- VENT DIA.. VENT MAT; HIGH WATER NUMBS R'OF ROAD 1PROP1111Y W
1W t L. BUILDING VENT EF S
HLAHM FEET FROM LINE (AIR I. ETA
❑YES NO
%i CIYES LINO NEAREST-
DOSING CHAMBER:
MANUFACTURER BSIPHf)E: '1NU, Ai:TIiHLi WARNING LABEL LOCKING COVER
PROVIDED PROVIDED
❑YES LINO ❑YES LINO ❑YES LINO
GALLONS PER CYCLE: PUMP AND CONTROLS OPERATION AL NUM EOMF PFIUPEHTY WELL JBUILDING JVINTTOFRESH
(DIFFERENCE BETWEEN _ FE F t-INF AIR INLET
PUMP ON AND OFF) ❑YES -!NO N "I
SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing ~i,a nMETEIe 'aATfWA,ANDMARKIN(,
or excavation. Of soil can be rolled into a wire, construction shall cease until FORCE
the soil is dry enough to continue.) MAIN
CONVENTIONAL SYSTEM:
WIDTH JLENGTH 1111 OF UIS7R PIPE SPA[Irv t ,VF 4+ -----"bIUL 1TIn .PITS LIQUID
BED/TRENCH TRENCHES ATEFr v. PIT DEPTH
DIMENSIONS 53
i f
GRAVELDEPTH FI LL DEPTH DISTft PIPF UISTH PIPF DISTR. PIPE MATERIAL NO DS", NUMBER OF PROPERTY WELL BUILDING jV'ENTTOFRESH
Br LOW PIP S )VI COVER ELFV III If ELEV FND ) PIPES FEET FROM LIN AIR~LET
NEAREST► C
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-
meets the criteria for medium sand. TIONS MEASURED.
I ❑YES LINO
SOIL COVER TEXTURE Hn1AVf NT MARKERS neSERVATION WELLS
_L_j! YES LINO ❑YES NO
I of- PTH OVER TRENCH BED DEPTH OVFH TRENCH BFI( DFPTH OF 7l)F'S(11L ti(IUUEU SfFUE 1) MULCHED
CF N7ER EDGES
❑YES LINO ❑YES LINO ❑YES LINO
PRESSURIZED DISTRIBUTION SYSTEM:
WIDTH LENGTH NO. OF LATF HAL SPACING ('HAVEL DEPTH BE It OW PlPI FILL DEPTH ABOVE COVER
BED/TRENCH TRENCHES
DIMENSIONS
MANIFOLD PUMP MANIFOLD DISTR.i3 MANIFOLD MATERIAL NODISTH UISTR PIPF DISTRIBUTION PIPE MATERIAL& MARKING
ELEVATION AND ELEV. ELEV. CIA ELEV. PIPES DIA.
DISTRIBUTION
INFORMATION HOLF-SIZE HOLE SPACING GRILLE D CORHE C T E Y COVER MATERIAL VE RTICAL LIFT CORRESPONDS TO APPROVED
PLANS
❑YES LINO ❑YES LINO
COMMENTS: PERMANENT MARKERS. OBSERVATION WELLS NUMBER OF PROPERTY WELL. BUILDING.
_ LINE
R % OYES LINO ❑YES LINO _ NFEET
C,.
r'
Sketch System on Retain in county file for audit.
Reverse Side.
SIGNATURE. TITLE
DILHR SBD6710 (R. 01/82)
Wisconsin APPLICATION FOR SANITARY PERMIT
D I L H . r~ COUNTY
oEPfiRTI-1EnT OF UNIFORM SANITARY PERMIT #
InOUSTRV, LR60R 6 HUMRn RELRTIOnS 7,-5-00
-Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 81/2x 11 inches in size.
-See reverse side for instructions for completing this application. PLEASE PRINT
PROPERTY OWNER MAILING ADDRESS
PROPER Y LOCATIO CITY:
VI ' GE:
/E 1/4 = 1/4, TN, R e% E (or) "TZ w F:
LO NUMBER BLOCK NUMBER SUBDIVISION NAME ]NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER
TYPE OF BUILDING OR USE SERVED
1 or 2 Family Number of Bedrooms. 7 ❑ 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.
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
❑ 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
Manufacturer: k
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):
L S 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): r Signatures MP/MPRSW No.: Phone Number:
Plumbe stress: Name of Designer:
COUNTY/DEPARTMENT USE ONLY
Signature of Issuing Agent: Fee: Date:
❑ Disapproved
0
I ~J ❑ Owner Given Initial
CyZ 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
i
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/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.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
i
Owner of Property
Location of Property Section T_ ~LN-RW
Township
Mailing Address PT cz
Address of Site
Subdivision Name
Lot Number
Previous Owner of Property
Total Size of Parcel Date Parcel was Created l J
Are all corners and lot lines identifiable? Yes No
Is this property being developed for resale (spec house) ? Yes No
Volume and Page Number /3 9~, as recorded with the Register of Deeds.
INCLUDE WITH THIS APPLICATION THE FOLLOWING:
A Warranty Deed which includes a Document number, volume and paFze number, and the
Seal of the Register of Deeds. In addition, a certified survey, if available, would be
helpful so as to avoid delays of the reviewing process. If the deed description refer-
ences to a Certified Survey Map, the Certified Survey Map shall also be required.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
PROPERTY OWNER CERTIFICATION
I (We) ceAti.sy that aU btatements on this 6otcm cute tAue to the best o6 my (ocuc)
knowledge; that I (we) am (ate) the owner.(t,) o6 the pAopetcty dacAi.bed in this
in6o,mation 6otcm, by vi,tue o4 a watucanty d ed tzecotcded in the 066ice o6 the
County Registeh o ~ Deeds a.5 Document No. ,s J and that I (We) pkez entt y
awn the puposed site 6oh the sewage d spos system (ott I (we) have obtained an
easement, to Aun with the above desnibed ptcopehty, 6o.'L the conattuction o6 said
.system, and the same hay been du ty necottded in the O{6ice o~ the County Register o6
Deeds, as Document No. jgf f? 6, ) .
SIGNATURE OF 0 ER SIGNAT E OF CO-OWNER (IF APPLICABLE)
Sy 'r c -
,Z-
DATE SIGNED DATE SIGNED
0
o
u;
r ~J
C.) O to r o
C a O _
C, C)
I C,~ W C [l 1-.
17
cr
f ) r- r1
0 u,
y `'u .;is r L1. H C) C~
w T y
< C
-N o Y? o to
t7 ` (n c_, r a Ca
O n co n < Z Cr
N
r~ IT W
r r;
r < 3 (D
U d C r N co t7
> to Cr r ;
r ` C=7 G;
tT)
z W O C;
H
d z c
ri
d
ALL BEARINGS ARE REFERENCED TO THE EAST
LINE OF THE NE 1/4 ASSUMED TO B"'AR NORTH. n o
Cv
unplatted_l~,r_:ds_owned _by,oth_ri m
OD
O O c' _
J
_ <
i J
I w
v R O w % r
O FJ w
co 00 j
CG!
ca c , J) V - o
ur I-- 0
j CD
x c~ r.
- + 0 x w t~ ~
C? 0
H Ul i C
O0)
o ° z r~ O -
L> N H W t-~ G] O
O N F- W ;D N - W Go I J !g~•t-=~ y s
c~ ~co o - v co ld oo r,)
o r~ tai n~ t\ c o I rt
7- V11
co 0) of r
O 1(G ul ' r)
a m ~ w o > co m 1 Q. o
c)o nN C) co no - i -'U,
t~ t" Cy1 co t) (n M CI)
to 0 cr TJ s I f~ w >
m J0 f), JO Q, 10
X h ` X X I (D 1
.i.
r r r o I !r, 9°
d Ci o' a e
t
o
ri n C) n ,c o ;u
I(D
C ~
!l
124. 3' !.22.00' N
~ 7 1 . 5 C ' 2.83' ° <
SOlo24' 101117 546.33'
w Co CD
L-1
ww V V s n
0 0
tn; ~l ftt:cd lar)d!~s oar,l( d E) others tvv O O
- r
r
C -I) C -0
in n) N cn N w
7 •-Y
n 1270.02'
r• 1270.12(r) o 7
L4 -.~~,r -
NORTH
N r EAST LINE OF THE NE 1/4 ~f
H
z
cn
H
a
ST C- 105 r
r
_ a
_ H
SEPTIC TANK MAINTENANCE AGREEMENT o
St. Croix County z
r
OWNER/BUYER
ROUTE/BOX NUMBER I Fire Number
CITY/STATE ZIP ~7~
f
Section TN, RW,
PROPERTY LOCATION: Z11 F-7
Town of St. Croix County,
Subdivision Lot number
Improper use and maintenance of your septic system could result in
its premature failure to handle wastes. Proper maintenance con-
sists of pumping out the septic tank every three years or sooner,
if needed, by a licensed septic tank pumper. What you put into II
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.
0
E
I/WE, the undersigned, have read the above requirements and agree rz„
to maintain the private sewage disposal system in accordance with x
H
the standards set forth, herein, as set by the Wisconsin Depart- lv
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 L
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.
r
N
av a v; w c c N3 0
N ' (D CD 11 0 lD °
y ° Q 3 1 W =1 =r N
C ~ Z
O ° LU
to 0 =r CD ~o CL CD D
~D j CD N m N N j 4
CL 0 0 0 - M = co I C) 3
CD -
V ° w c~ =:Z v< _ Rr
L 0 a o- m w
> > g co o 0 o f°
r. ~ ~ = > w c
C 3°C ,<~c.~n~
pM,i w~ c l< Q a 0
CD _N
O w? N 0 N CL CD m
n ~o w ~m~c" 2
<mc cnQ0
N N o D c m
c c s '0 L:a w 0
~n 0° C L CD 0 w p
m ? m cn CD wwN C CA
w D
m ---f :3 0 Z
n N (D m n CD
-r OL
n.mn 3~CDCD= D
CDi c m 0 w (D (n . > D
=r :E Q cn m _-x
C.1 CD =
= w - a C n :E CL CQ
CD
\v m ° -N'cn w w c fTi
\m (DC~ 0OL CD
M (n CD Cn CD o n
CL (D ° o y o o= c cn D --1
rr--
Yl CO o 0 C r. c m
a CD c° n N
CL o' Ri
o f N c , aN
W w (D - 0 (D N
a ~ CL
Q N° CD Q w- Z, (a
c cn w =r cD
N. N° O C 3 N n
CD n c to :3 CD CD
0 0~ n M O ~ O
CL ° o (n n. C ~ -
CL caw ccD
=r~, r. ° CL
# n. c - (D
'ai a3 ° ° -3
w 3 _am o 3
i CO o CD
z
° Q> o
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: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK. NO.: SUBDIVISION NAME:
w
'M'44 31-1) TS) N/R 19 40(or) W -.5", -1;,- r; f
C LINTY: OW ER'S/BUYER'S NAME: MAILING ADDRESS:
}
ra e S i r Cs INN -;_I T S
USE DA AS OBSERVATIONS MADE
NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS:
Residence
I f New ❑Replace
LIN
3
a - i -Z3y
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENTIONAL: MOUND: IN-GROf RESSURE SYSTE-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:(optional)
~d ❑U MS ❑®❑u ❑S ®u _ ❑S su C~~, :.l
If Percolation Tests are NOT required DESIGN RATE: EFodplain, n
y portion of the tested area is in the under s.H63.09(5)(b), indicate: indicate Floodplain elevation: V
PROFILE DESCRIPTIONS
BORING TOTA ELEVATION DEPTH TO GROUNDWATER- CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
B- r g Pic '
B-_ 7 51 18 to 9 rx V-7 CS 6r\
B-3 8 q?~s :7 7` 97-a.SS a,
B- y ~N0 Q-,9 5,1 Cat ~,bs;rB~ s.76s 3,x s,Z-~ `s 6„
B-s g), 3 NQ :>7 o-.95r /,a/,, ~ 5d8 3-)_~.CsR ":-2'56,\
B-
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD I PERIOD 2 PERIOD 3 PER INCH
P-~ a 3-
P_ 3 [Do 6-
P- D ` :3 3
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
Ca
44 pp _
F ' _ ~ r ~ f I ~ C3
zt- _ ~ v
bt
rLj
f-o /coo - -
i 9.
E E
°T
%
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( pr t): TESTS WERE COMPLETED ON:
ADDRE , CERTIFICATION NUMBER: PHONE NUMBER(optiona1):
C~SIGNAC~ I
The usee, r &111 S
_ (s tn s _ E _ - ,
r r
IT Au .fi a CIN, A1-~ M" ..l .s ) i , 3. F_ _ E~ ~~,~E€
sst ~..1.° Mf fi La4 t`< .:,t. ~ j:i i, , >u° ai la k';'L
y.}.'
S f~}a a- 4l. t`ri ar fi~ ,war
_ ~Iol, ..:3% t
a.. f;,,. vllJ'; PJ, A c. the _,(3c +it)d.nc.',
E ?a ~4- d ~~5v t:fi Cfi w~~
fur"dol
~jh
~ E
Oz tly J'
C! a v L,
r
r PRO)ECT-, 'co ADDRESS
;(j~ C 1 /4 I /4A S3Nr j W TOWN ' e'r:u-T` COUNTY-
PLUMBER ISCENSE NO. MPRS3318 DATE 43"
' BEDROOM CLASS PERC_Z_ CONVENTIONAL IN-GROUND PRESSURE
CONVENTIONAL LIFT_ MOUND_ HOLDING TANK-
SEPTIC TANK SIZE LIFT TANK SIZE
DOSE TANK SIZE HOLDING TANK SIZE
ABSORPTION AREA ~
EA _Z~-~ PERC RATE ED SIZE i
LLH.R.P
. _:r+.ti•.:.ii of F:.r~ ti<:fiiiicl.i'~~
F'ri i; H<A c 1 le
T"(Ps"AR COVERING
eo
fro ,
p W5~ zo r rn en
i
411
c
d'
1
parcel 032-1086-50-000 01/25/2007 03:04 PM
PAGE 1 OF 1
Alt. Parcel 32.31.19.418B 032 - TOWN OF SOMERSET
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 - JANSEN, LE ROY R & JODI
LE ROY R & JODI JANSEN
1871 37TH ST
SOMERSET WI 54025
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description * 1871 37TH ST
SC 5432 SOMERSET
SP 1700 WITC
Legal Description: Acres: 3.020 Plat: N/A-NOT AVAILABLE
SEC 32 T31 N R1 9W 3.02A SE NE LOT 1 CSM Block/Condo Bldg:
VOL 5/1396 ALSO COM E1/4 COR SEC 32 N
401.70'N 87 DEG W 320.81'N 258.20'-POB Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
N 64.54'N 87 DEG W 645.66'S 44 DEG W 32-31N-19W
86.09'S 87 DEG E 705.56' -POB
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 792/165
2006 SUMMARY Bill M Fair Market Value: Assessed with:
145703 272,300
Valuations: Last Changed: 08/09/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 3.020 48,100 158,400 206,500 NO
Totals for 2006:
General Property 3.020 48,100 158,400 206,500
Woodland 0.000 0 0
Totals for 2005:
General Property 3.020 48,100 158,400 206,500
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 125
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00