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HomeMy WebLinkAbout036-2002-90-000 O d f C"1 O (9 C O S n N L A7 _0 7! (D 01 fD 0 C) O N Vl O N = d. 7 O C N rs 00 tD Z O N 00 a . O w 0) (n £ x No °:3 0 a- 0 0 O N 0 =3 =3 :E CD CD 0) = cri a) CD (D N 7y H ° 3 H a o° N N 0 W N W a ° H. rr O d m G N N a co td w a a z (D r1 _ ON 3 0 W (D 00 H N "d U'1 ~O Cd O W0:) CD N O C H Cn Cn v V) n CD z O O O ~i n ° Cl) E ° O Ln C) 3 PO CD 3 CO t) o n LI) =3 C) ~5~ U-1 * (D CD j y N CL (D CD I H. rt w t~ Z cn CL w N r co z ~ rt ' cn ZD W p 0 0 a v LTJ ~ • cn V v7 ° m CD rt t''' E', (D (D N w o r v G~ rr rt rt (D cn H F- c m m U) - 0 0 W d cn W a rt R' N 7 (D 110 W p D p Z m O n A Z lv i r. V7 O Cl) (n W _0 m _ co fD CD Z CL 3 O r. CO O m -4 I ~7 (D ? W N C> CL a 3 w m v n ~ O Z3 -n 3 m c 0 o a (D ~ N v a I ~ 4l j ti b N O O a ~ A O ro b (D 0 0 ~ A a ° C) CL ~I Parcel 036-2002-90-000 07/18/2006 05:34 PM PAGE 1 OF 1 Alt. Parcel 31.31.17.628B.629 036 - TOWN OF STANTON 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 JEREMY S & KELLY L GESS O - GESS, JEREMY S & KELLY L 1809 147TH ST NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 1809 147TH ST SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 0.603 Plat: 2238-OAK RIDGE ESTATES LOT 9 & S1/2 LOT 8 OAK RIDGE ESTATES Block/Condo Bldg: LOT 09 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 31-31 N-1 7W Notes: Parcel History: Date Doc # Vol/Page Type 08/01/2002 685687 1939/49 WD 07/23/1997 1190/130 WD 07/23/1997 1007/202 WD 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/03/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.603 20,000 114,700 134,700 NO Totals for 2006: General Property 0.603 20,000 114,700 134,700 Woodland 0.000 0 0 Totals for 2005: General Property 0.603 20,000 114,700 134,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 10/10/2005 Batch 05-30 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ' Parcel 036-2002-80-000 07/18/2006 05:34 PM PAGE 1 OF 1 Alt. Parcel 31.31.17.628A 036 - TOWN OF STANTON 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 - RORABECK, DANNY B DANNY B RORABECK 1355 AWATUKEE TRL HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 0.603 Plat: 2238-OAK RIDGE ESTATES LOT 8 EXC S1/2, OAK RIDGE ESTATES Block/Condo Bldg: LOT 08 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 31-31 N-1 7W Notes: Parcel History: Date Doc # Vol/Page Type 05/26/2005 795904 2809/116 QC 09/07/2004 773667 2651/124 WD 09/07/2004 77672 2651/156 QC 12/10/1999 615303 1477/316 QC mor 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 08/27/2002 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.603 8,000 0 8,000 NO Totals for 2006: General Property 0.603 8,000 0 8,000 Woodland 0.000 0 0 Totals for 2005: General Property 0.603 8,000 0 8,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ' Form- S T C - 104 F AS BUILT SANITARY SYSTEM REPORT OWNER°_ TOWNSHIP ~~r~✓.."7 SEC.~~~_ T 5/ N-R) W ADDRESS ST. CROIX COUNTY, WISCONSIN ",4 ~ d SUBDIVISION LOT C/ LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of ILHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM T., ,7, a INDICATE NORTH ARROW ce -Z,0, BENCHMARK: Describe the vertical reference point used CC A Elevation of vertical reference point: lov Proposed slope at site: ^ SEPTIC TANK:, I a a c~Darer: C9 Liquid Capacity: J ~Nut~e~ kf rings used: _ Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: Number of feet from nearest Road: Front, ~Side 10 Rear, 0 feet From nearest property line Front,0 Side, Rear, 0 feet Number of feet from: well, building: i+ (Include this information of the above plot plan)( 2 reference dimensions to septic tank) 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, 0 Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: I Width(2) Length: Number of Lines: Z, Area Built: Q, Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side, Rear,O Ft. 7 Number of feet from well: r 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: 7 C1 Plumber on job: License Number: `T 3/84:mj 1 DEPARTMENT.OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING MADISJN, WI 53707 CONVENTIONAL ❑ALTERNATIVE State Plan l).D.Number: assigned ❑ Holding Tank [:1 In-Ground Pressure ❑ Mound ( If NAME OF PERMIT HOLDER. JADDRESS OF PERMIT HOLDER. INSP CT N DATE: Donald B. Schultz R. R. 3, Box 320D, New Richmond, WI- BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.: CST REF. PT. ELEV. SE'-, SE,, Sec.31, T31N-R17W, Town of Stanton, Lots 8 & 9, Oak Rdg. Est. Name of Plumber. MP/MPRSW No.. County Sanitary Permit Number. Gary L. STeel 3254 St. Croix 64885 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LCAPACITY. jTlkNK INLET ELE V.. TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER / PROVI DED. PROVIDED: ❑YES ❑NO ❑YES ❑NO BEDDING. VENT f VEN HIGH WA R MBER OF ROAD: PROPERTY WELL. BUILDING VENT TO FRESH % ALPR EET FROM LINE-. LAIR INLET ❑YES ❑NO YES ❑NO EAREST DOSING CHAMBER: MANUFACTURER 7YING JL IOU D CAPACITY PUMP MODEL PUMP/SIP ON MANUFACTURERWARNING LABEL LOCKING COVER PROVIDEDPROVIDED: ES ❑NO ❑YES ❑ND ❑YES ❑NO GALLONS PER CYCLE: P UMP AND CONTROLS OPERATI N.L. NUMBER OF PROPERTY WELL. BUILDING (VENT TO FRESH (DIFFERENCE BETWEEN FEET FLINE AIR INLET PUMP ON AND OFF) ❑YES NOf JNEARENM-~ L ABSORPTION SYSTEM. Check the soil moisture at the depth of plowin I FNC;TH DIAMETER MATERIAL AND MARKING SOI or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: WIDTH LENGTH NO. OF DISTR. PIPE SPACING COVER JINSIDE IJIA 31IT1 LIQUID BED/TRENCH TREKC~S MAT AL PIT DEPTH DIMENSIONS / LZ) C GRAVEL DEPTH FILL DEPTH DISTR. PIPF D I S T R PI E~ DISTR. PIPE MATERIAL: NO'. DI T NUMBER OF PROPE V WELL'. BUILDING. VENT TO FRESH BE. LOW PIPES ABOVE VER. Ell laJLET ,,EEyt/% E / _ PIPES ~ LINE. ~ AIR INLET: FEE' i I iif~~ j ` / NEARESTO ► / 7 ~ x. ^ 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. ❑YES ❑NO SOIL COVER TEXTURE PERMANENT MARKERS JOBSERVATION WELLS ❑YES ❑NO ❑YES ❑NO DEPTH OVER TRENCH; BED DEPTH OVER TRENCH BED DEPTH OE TOPSOIL SODDED SEEDED MULCHED CENTER EDGES. ❑YES ❑NO ❑YES 1:1 NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH. LENGTH. NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPF FILL DEPTH ABOVE COVER BED/TRENCH TRENCHES. DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL. NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING. ELEV. ELEV.. DIA. ELEV.' PIPES CIA.. ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS ❑YES ❑NO ❑YES ❑NO COMMENTS: PERMANENT MARKERS. OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING. FEET FROM LINE. ❑YES ❑NO ❑YES ❑1 NEAREST ~I Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE TITLE. DILHR SBD 6710 (R. 01/82) ' r WISEOnS1n APPLICATION FOR SANITARY PERMIT ` ~ Dl LHR COUNTY (PLB 67) UNIFORM SANITARY PERMIT # OEPRRTTEr1T OF Ir1OUSTRY, LRBOR 6 HumRn RELRTIOnS -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 P TY OWNER MAI ING ADDRESS Z- ~3 X 3 z~ /l~ 2cs i e~ u11 n 41 le. PROPERTY LOCATION G+TY 6- 114S C- 1/4, S 31 , bf N, R (or) W TO OF: LOT NUMBER BLOCK NUMBER JSJONEAREST OAD AKE OR LANDMARK STATE PLAN I.D. NUMBER Y~ P_ 40 ~l%SZH ~S ne C1 'IV TYPE OF BUILDING OR USE SERVED 1'e"JI C~ 1 or 2 Family Number of Bedrooms. Public (Specify): THIS PERMIT IS FOR A: ❑ New System ❑ Tank Replacement ❑ Repair Replacement Soil Absorption System ❑ Revision ❑ Privy ❑ Alternate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. ❑ 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 S/~ 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 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): ~Q Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installat~ay of the private sewage system shown on the attached plans. Name Plumber (Print): Signature: fotP/MPRSW No.: Phone Number: . - f 6 2 jA4 ,Z s- ' ('71-s' )2- e Plumber's A ress: ame of Designer: COUNTY/ DEPARTMENT USE ONLY jSjignate of Issuing Agent: Fee: Date: ❑ Disapproved ~✓~I L~ Owner Given Initial 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 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. I APPLICATION FOR SANITARY PERMIT STC - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequaoies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractgr,("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 f Location of Property sL iy, Section ~T 3L N - R ) 7 W Township to Mailing Address & 3 Q 3 2-o ID -r Subdivision Name ©et IC ~Lce- f_g S Lot Number J L g , \j 12 V/~ Previous Owner of Property 6' Total Size of Parcel Date Parcel was Created Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes_ No Volume and Page Number d.) 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) eeAti.6y that att statements on .this 6o4m ane tAue to the best o6 my (ouM hnow.tedge; that I (we) am (ahe ) the owneh (s ) o6 the pnopen ty des cAibed in .th i,a .in6o4mati.on 6onm, by viAtue o6 a wava.nty deed heeotded in the 066.iee o6 the County Reg-iA teh o6 Deeds as Document No. ` 3 Z ; and that 1 (we) pneaentey own the proposed site bon the sewage pos system (on I (we) have obtained an easement, to &an with the above deseh,i.bed pnopen.ty, bon the cons.tAucti.on o6 6a.id system, and the same has been duty tecoxded in the 066ice o6 a County RegiA ten o6 Deeda, as Document No. IG ~ATTURE OF OWNER SIGNS 7URE F CO-OWNER (IF AIPPLICABLE) 6A A SIGNED DATE SIGN D H z H 9 STC - 105 r r 9 H SEPTIC TANK MAINTENANCE AGREEMENT Ho St. Croix County z d 9 H OWNER/BUYER Ai"~ A ~.o ROUTE/BOX NUMBER R93 o x ZOO Fire Number CITY/STATE Aleie~ 1K, C- I--,.,,..~ 7.IP 51M 17 PROPERTY LOCATION: C% ~4, _5e Section 3( T31 N, R17 _W, Town of SaV, 1_O16-, $ t. Croix County, Subdivisionoo-kkJ~~, Lot number ''S`1' f I Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treat- ! ment stage in the waste disposal system. St. Croix.County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. 0 E I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with x H the standards set forth, herein, as set by the Wisconsin Depart- Iv ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zonin Office within 30 days of the three year expiration date. SIGNED DATE S~ 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. ~ N r m = 7 ) 7 W N ¢'1 CAD CID m o 0 m: D 0 n =r N w Co C 0 co cG j 3 j (D 0= Z 0 j N N I* O N~~ N O a 0 w O m w= ~ g m a m a m ~m aN? R~ 0. wa~ n cn w m =T 0 o m m CO c, 3 a co co w w~13: O ~C c - c o c ~c 3 5- 0 czto oc~z a 0.0 w s Im w w v_, o ono L!~ :3 = w a ='00 "v-0 - CD 7 C7 Q N t0 Q ja la < CD / N o c, 0 Dw m o coca Im O , Z D 06 0NCD ou CO CD N (in ao, m Cl) w co Z w = w m o a CND o CD CL 3 Ch N cc m m N c ° w o= o Q N io CD = a cm w N a ac0f(D C m m m c = o am ~v, C7 A ~ ~ m CA Q W = CL to 0 - 0 o m~ m w 0 7 m 0 N ID Y/ 3a cQccf=• m =3 M CO :3 0. a- CL 3~ ?N aoCD v c N c BUD m 3 c _no )com oN c~cm~, s 0 c a m m o co c -i m .o0 V Boa Boa =rCCD gu -0 ac 3 o f o 3 °Q . 3 w a a ° o N 0 o y ` 'o DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, - DIVISION LABOR AND' PERCOLATION TESTS (115) MADISP.O. BOX ON WI 7969 HUMAN RELATIONS (H63.09(1) & Chapter 145.045) LOCATION:,,-. SECTION: TOWNSHIP/WfiT ~L-I-TY: LOT NO.: BLK. NO.: SUBDIVISION NAME: /T.31 N/R/1/k (or)W I A) 04: COU T OWNER'S/Q LXE S NAME: MAILING ADDRESS: i3 S~~ u ~ fz {2#~ 320 p q~ ' - 121 111 USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: (PROFILE DESCRIPTIONS: PERCOLATION TESTS: rryy~~~~ 13 rtesidence J ❑New Replace RATING: S= Site suitable for system U= Site unsuitable for system l CONVEcNTION'AIL: M' :CN-GROOUND-PRESSURE: RSYSTEcM-IINN--FILLHOLDIING TANK: RECOMMENND/ED SYSTEM: (optional) X] E:]E:I If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the ) under s.H63.09(5)(b), indicate: / ~ Floodplain, indicate Floodplain elevation: /v' 0FsIW?A(I PROFILE DESCRIPTIONS Zo '6V '0 BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER 9,Ep44++J, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) U B- C7 > 7 B- 7_ JOJ ~.5: ~o c3~, m,s '45 7 3 B-3 7 loo- 40 f) B- B- B- ~Sim~l PERCOLATION TESTS TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER S AFTERSWELLING INTERVAL-MIN. PERIOD1 PERIOD2 PERIOD3 PER INCH P- / C 3 Co < 3 P- 2- S' C P- 3 -C 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 9 3 9 'S A-!0 4 10 I F F ►nalNad .3 SSG ~v sR6'f~ atrK a. ~E Vo b&- ov_~ ,~o e-od 6-7f O Pa,J, , f 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 (p TESTS WERE COMPLETED ON: ADD CERTIFICATION NUMBER: PHONE NUMBER (optional): CST SIGNAT E: 19, DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - and anni me3 so ! m r, yours €ax,rt mns t h a ds-W Astp Ni s c a:3ton, F 1, , use°i,_m sew! a, ,ens .t .','iEeM this v . . , A -;ta £ a rinme ck! € roje .L; .U,. sv {Jive .orrflJ ,i of ha,r.«?t 3.. zi7?m m.se no nsa rw3{. Cu ld We n=00ly i_ yj ha fa. it WE HS UFT ~ til t-. F~' ss' A HOI. INN Tiklv3< ONLY 1F ALL O 3lER HAS f'xRL.. RULED OUT BAS'E PLEASE . '.x Me <;bbt <.GI invis shaman 'wre for mi k ng ttruk A t t A:Wns aim! currEplei.Ng to! ~&at plan; i'A;AK ?T A L as E !ur rn .:Em ady [;w.?t&g i . # loc:«mr1' g lo i [ "t' e s`.hwat sh m rn az I ass*, f ysaPc:d; tV=i ke Si me A °si "O . and to W P b. 1M « W;. t VIt 01" cluwly 5` o«an YA are p rn-v,«1t id; «snnr"tit ' ._€e x, .F,££ , We «.ox,=',il a to _ho, natT€ s, aiEv i ep i'. }d p r`r a, ktc<, a.,c,fi[«Al"t an e°, ;(s'V-" by ~ - ri q4v ng hoe: av rr h t riot anpit, id ~ t s AJI1 r t X13- , _ a 10-) 311 HwHxP no C}W 0 in"; cFa a.. <_ty-.'; _ d N,.: x«31 !€-E 4 Vii, •d t~l Es`(Sl e yt i<"r'' N F . «:awid Bow 3: I nfj C - Lonmy ,fit r t;.. i ho'"'€ 0 S& my t Own Los Tin a v-, a4 n - t f` C a, ? s _ , - R en pt W", asn Wit, nislar-, _ O H . WN, n:' rly t r r€,n . K S! I v' IV T231 . l~'I=~~ ~E msr► i t'oc' .5 )34- lo 0 /00 St. Croix County Sanitary Maintenance S~~y. Stec. 31 l ~t- Certification Form for system installed during 1985 ~OL~`` v~G2h'~ I-t;ks --------1. The private sewage disposal system is in proper operating condition. ----~--2. The septic tank was recently pumped by a licensed septic tank pumper, or it was inspected and is less than 113 full of sludge and scum. Signed by Title ~4 r r ~ Time Day. Month Year `l Signed by Owner r~ r DaY Month 1, Time Year Make occupant or address corrections here