Loading...
HomeMy WebLinkAbout038-1115-20-000 m o d n o' 0 `+1 cD o m f c 'n 3 (D n1. c CD -(D A ~ y 3 Z O O 2 N O eC• 0 co w P" CL O z Cl z y y i M c :3 CD 00 W Q M N p) to ~ ~ .p N r! NO 0 7 Q (D r ~ o ►.j Q cn U~ 7 x m e A CD p CD O p O W O O C (D ~O C d ° O (D t-li rt U(D F~ V] O y .1~ O H. Z ~ a c rn c°n ~ w E c O O r° 4- (D cD 00 r C oo 03 CD Ul (.n tnn 0 P (D Go -1- M I~ O O O ° tr. H n z \ 9 N o o D I~- y O D CJ d N m m cr p p O N N m y c (D (a C4 N) U N I J- N O N N 3 co N o w UUi b w :V, z In F, > CD 0 O TJ Fl "Nit • (n (D o m CD E (D cAD v x n W rt c CD (7 N y N. w a ( p cD (D n 3 CD N O U) N O N C A 0 O O ~o (D p rfi a A 0 R f-I rt Z N w Co v m m n a 4 z 3 `a ~ 0 oo y Z1 (D A w ~ c) CD o n O CD d j G a N - (7 - 7 (n o a y O ~ y O =r ° o y C A CD ~ A a CD n N y O ii y N CD O 3 c V I A O 'T1 'v ti cD i V w 69 ti W O ° O O i 00'0 00'0 00'0 le;ol sa6Je40;uenbullea sa6Je40 leloads s;uawssessy lelaadS ;unowy ti06a;e3 ap00 leloads Jasn :sleioadS 091, 431e8 :a;ea u01;e31;ILje3 6 :;uno0 wlel0 ;}Ipaao /(.lapo'l 0 0 000'0 puelpooM 008'tb9b 009'6LE 00Z'98 0917'OZ AtjedoJd IWOUGE) :9002 Jot WWI 0 0 000'0 puelpooM 008'ti9b 009'6L£ 00Z'98 09b'0Z A:podoJd leJauaE) :9002 JOI sle;ol ON 009'tiZ 0 009'bZ 000'8 1N99 1S3210--J iv2iniinoiHev ON 009'[ 0 009' L 000' L L t19 iHi`I -nno1b9`d ON 009'8Eb 009'6L£ 000'69 09b'L L9 IVUN3aIS321 uoseem a;e;S le;ol anoJdwl pue-1 saJOV sse10 uol;dijosea SOOZ/ L£/SO : pa6ue40 Ise-1 :suoljenlen ;uauassassy onlen esfl 8£L69L :4;Inn passassv :anlen;aIlJBW Jled Me Auvwwns 900z Z6S/£99 L66 L/£Z/LO ad~(1 VVV __06ed/Ion, # ooa Oleo :tio;slH IaoJed sa;oN MOZ-NO£-£Z 8Od-13 Z8'bZ£ L M 93468 (t'4 09L tl/L 0t7 6uZl-UM 1-046) :(s);oeJl N H113 L6'ZL9 N H11.4 t78'SZ£L 3 93468 S :6p18 opuo Hl ld L6'ZL9 S Hl 8Od-13 88'Eb9 S Hi CZ 0/M3018 03S HOO b/L N W00 3N MN MOZ2l NOEL £Z 03S 318VIIVAV lON-`d/N :leld 09t7'0Z :saJOV :uol;dliosea le69-1 011M OOL L dS NosanH L L9Z OS 12:1 dVYVO inOOS N3S2i3aNV ML uol;dljosea #;sla adAjL tieu,ud :(se)ssa.ippy ApedOJ d 1e13adS = dS I0043S = 0S :s;olJ;s!0 Z90179 IM NoijnOH 181 dW o inOOS N3SH3aMd ELK 9 30INVP V O NIn3)4 'H31130W - O 2331-130N 9 30INdf '8 J NIn3N jaumo-oo iuanno _ 0 'jaumo waimo = 0 :(s)JOUM0 :sseippy xel 0 00 adAl;lwJad #;IwJad # uol;eollddd eaJd sales # deal a;ea leolao;s!H a;ea uol;eei0 NISN00SIM '.l1Nf100 xioHo as X ;uaJJn3 Hd3S0f 1NIVS 30 NMOl - OEO 89b~'OZ'OE'EZ # IaoJed 1IV 6 d0 6 3E)Vd Ad 9C:Z4 LOOZ/6Z/LO 000-0£-MZ-0£0 1001ed Parcel 038-1115-20-000 01/29/2007 01:12 PM PAGE 1 OF 1 Alt. Parcel 29.31.18.487D 038 - TOWN OF STAR PRAIRIE 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 - PATTERSON, ZANE ZANE PATTERSON C - BIBLE, LUANNE LUANNE BIBLE 1987 93RD ST SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1987 93RD ST SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 0.000 Plat: N/A-NOT AVAILABLE SEC 29 T31N R1 8W PT NE NW BEING LOT 1 Block/Condo Bldg: CSM 10/2928 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 29-31N-18W Notes: Parcel History: Date Doc # Vol/Page Type 07/12/2004 768448 2614/064 WD 07/23/1997 765/54 I i 2006 SUMMARY Bill Fair Market Value: Assessed with: 175654 190,700 Valuations: Last Changed: 10/14/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.000 67,300 101,200 168,500 NO Totals for 2006: General Property 0.000 67,300 101,200 168,500 Woodland 0.000 0 0 Totals for 2005: General Property 0.000 67,300 101,200 168,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 130 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Form- S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER - TOWNSHIP SEC. TN-RW v 1 ADDRESS ; ST. CROIX COUNTY, WISCONSIN _r b SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of ILHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM I i INDICATE NORTH ARROW r/ I - BENCHMARK: Describe the vertical reference point used Elevation of vertical reference point: Proposed slope at site: r SEPTIC TANK: Manufacturer: Liquid Capacity: MOO 0"/ Number of rings used: Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: Q. Number of feet from nearest Road: Front,O Side,o Rear , feet From nearest property line Front,(Q~Side,O Rear , /S feet r / Number of feet from: well building: Z~ (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER M ti 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: Width: /Al Length: Number of Lines: Area Built Fill depth to top of pipe: 17 Number of feet from nearest property line: Front, Side, O Rear, O Ft Number of feet from well: 2~ /GO 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: 2 - License Number: Tr.~ 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 MADISON, WI 53707 ate lan ♦ CONVENTIONAL ❑ALTERNATIVE Sltf assPgnedliD. Number: ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER. ADDRESS OF PERMIT HOLDER: INSPECTION DATE. HALVERSON, LYLE R. R. 1, Box 146A, Somerset, WI -3 4S -4'od BENCH MARK (Permanent reference re mtl DESCRIBE IF DIFFERENT FROM PLAN REF. PT. ELEV.. CST REF. PT. ELEV.. NW NW, Section 29, T31N-R18W, Town of Star Prairie, Halverson Pk. Name of Plumber. JMPIMPRSW No.. County. Sanitary Permit Number Cal Powers 1563 St. Croix 64887 SEPTIC TANK/HO G TANK: MANUFACTURER'. LIQUID CAPACITY. TA INL T ELEV.'. TANK OUTLET ELE V.. WARNING LABEL LOCKING COVER s - PR OVI DED. PROVI EDj. L YES ENO L~ft S ENO DING VENT TO FRESH BEDDING VENT DIA.: VENT MATL. HIGH WATER NUMBER OF ROAD: ~r JP ROPERTY WELL. IB111 I ALARM. ' FEET FROM !I LIN AIR D YES kl/O ❑ Y NO NEAREST 1CVw( DOSING CHA BER: MANUFACTURER BEDDING. L QUID CAPACITY PUMP MODEL JPUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER PROVI PROVIDED'. DYES ENO YES ENO DYES ENO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. NUMQ.E F OP RTY WELL BUILDING (VENT TO FRESH (DIFFERENCE BETWEEN FEET LINE AIR INLET PUMP ON AND OFF) EYES ENO INEA, S SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing LENG, H IDIAME EH MATERIAL AND MARKING , or excavation. (If soil can be rolled into wire, construction shall cease until FORCE MAIN ° the soil is dry enough to continue.) CONVENTIONAL SYSTEM: WIDTH. IL NGT NJDISTR. PIPE SPACING. COVER INSIDE CIA. #PITS LIQUID BED/TRENCH TRENCHES Atf-HIAL PIT DEPTH DIMENSIONS ) 11 C GRAVEL DEPTH FILL DEPTH DISTH. PI F DISTR. PIPE DISTR. PIP TERIAL. NO. R.y NUMBER OF PROPERTY WELL'. BUILDING: VENT TO FRESH BELOW PIPES f. ABOVE OVER ELEV. INLET ELEV. ND S LINE. - AIR INLET FEET FROM ~NEAREST_ ti- 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. DYES NO SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS DYES NO DYES NO DEPTH OVER TRENCH: BED DEPTH OVER THE CH; BED DEPTH OF TOPSOIL SODDED SEEDED MULCHED CENTER EDGES DYES ENO DYES ENO DYES ENO PRESSURIZED DISTRIBUTION SYSTE : WIDTH LENGTH. NO.OF LATERAL SPACING. GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER BED/TRENCH TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL NO. DISTR. JDISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING. ELEV.. ELEV.. CIA. ELEV.. PIPES DIA.: ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL PLANSCAL LIFT CORRESPONDS TO APPROVED DYES ENO DYES ENO COMMENTS: PERMAN NT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: FEET FROM LINE ❑ YES ❑ NO ❑ YES ❑ NO NEAREST Sketch System on Re i in county file for audit. Reverse Side. ~71 SIGNAT UR TITLE DILHR SBD 6710 (R. 01/82) Wisconsin 7 APPLICATION FOR SANITARY PERMIT s COUNTY ILHR (PLB 67) UNIFORM SANITARY PERMIT # OEPRRTR L n-Rr OF ~.In DUSTRV, OF 6HUTRn 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 770-MY-0 WNR MA ING ADDRESS R RTY LOCH ION V I LLAmG E : 1/4 1/4, T N, R E (or TOWN OF: LOT NUM E BLOCK UMBER SUBD SION NAM NEARES ROAD, LAK OR LANDMARK STATE PLAN I.D. NUMBER TYPE OF BUILDING OR USE SERVED X 1 or 2 Family Number of Bedrooms: Public (Specify): b THIS PERMIT IS FOR A: ❑ New System Tank Replacement ❑ Repair Replacement Soil Absorption System ❑ Revision ❑ Privy L _J 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: 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): .2 Q( Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the prate sewage system shown on the attached plans. Na of lumber IP nt): Signature: i % MP/MPRSW No.: Phone Number: r 4. Plumber' Address: / Name of Design r: 4 _j COUNTY/ DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: ❑ Disapproved 9/ ❑ Owner Given Initial J / Approved Adverse Determination r 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 X r 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. 1b APPLICATLON FOR SANITAI"'Y PERMIT S 7' C - 100 This application forii Ls to be completed ill lull and signed by the owner(s) of the. property being Bevel ped. Any inadequacies will only result in delays of the permit issuance. Slioul.d this development be intended for resale by owner/contraccur, ("spec lumuse"), then a record form should be retained and completed when the property is sold and submitted Lc this office with the appropriatt.• deed recording. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ,J - t-Owner. of Property Location of Property --~4, Section , T AL N - R U Co t. M;i i I i ng Addr~°s'' Subdivision Name Lot Number P r e v i o u s Owner of Property Total Size of Parcel Date Parcel was Created ~Arty all corners and of lines identifiable? Yes No Ls this property being developed [or resale (sp(-'c house) Y - Yes - J~ VO I uine a d Page Number as recorded With th the INC UDE WI.T11 THIS APPLICATION ONE OF THE FOLLOWING: 1. Warr;mty Dc C-2 . Land Contra .t " 3. Other recor ings filed with thc~ Register of Deeds Office lu addition, a certi-ied survey, if available, would be helpful so as to avoid delays oI the reviewing prowess. if the deed (lescription references to a Certified Survey Map, Clio the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (Wc.) ec.n i6y that t ataternents on this ~onm ahe tAue tU the best o6 my (oun) I.nowke_dge; that I (w) am (ane) the owneA(h) o~ the pnope.nty dezceLibed ivi ,tGws 4n()uAma.tion 6o m, by viAtue. ob a wahA ty deed neconded in the 066iee o6 the County Re9t h o6 ~ D eds as Doeumerlt N 3'' ; and that I (we) , 3 S/--- pn~sen,ay own ,the pn po6ed site 6oh. ti Sewag diSpoSai system (on I (we) have obtained an e,Lsement, to nun with -the above d"mibed pnopenty, ion the constAuction )6 said System, and the same hays been duty neeonded in the O~6ice u6 the County Register o6 Deeds, as Oucument No. ) . SIGNATURE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED u H r-3 y r S T C - 105 r y H H SEPTIC TANK MAINTENANCE AGREEMENT o z St. Croix County d y OWNER/BUYER ROUTE/ BOX NUMBER~ ` -Fire Number_ CITY/STATE?-~.2 ZIP S e c t i o n ~a , TIT N, R ~~--W , PROPERTY LOCATION: i St. Croi)j County, ar.r ti Town of Subdivision , Lot number 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 con affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix County residents maw 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 thi4 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 master ponmbera certification form, signed by the owner and by Journeyman plumber, restricted plumber or a licensed pumper veri- lying that (1) the on-bite 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 ti three year expiration. ° I/WE, the undersigned, have read the above requirements an agree x to maintain the private sewage disposal system in accordance with 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 d'ate. SIGNED DATE__ St. Croix County Zoning Office P.O. Box 96 Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address. Z i O OI ~ py a) `m a) > O -a .C 1 E o c c~ c~ 3l~ m E o o E c as , -+Os a 0 0 a) t 'a p C qA a~ 00c~L0 U i cn 0 C 0) 0 In O i o (D 7 C N j V cn N ) co ~ ~ i N C7 ~ ~ C 0 3 CD m C~ 3 0.0 E co v>>!= o u) N°~C•-0co 0»-~ cm U O c V t N(D c° °a 7 E cc CC F- E ca co of N O( t w a~3U:3 caN d V1 3 0'D t cn ai N co C C U L _ 'a Co W Z0L3Yo Q Q ~soa)(,E ~conc °ro F- 3 c-Z co ms co Z p cm 0 3 N H S Q Z ~~a,L0 aD C;o ; N N- cti a-C C 0D "y O 3 -0 0 CL s = cc O D U -co to a ~a)._OQ0 0U) a) a ~ N T- C L 7 a) ~ ca a) aa~~- CO C Q C "'a 0 0 L 0 (n m m ca c 3 c n , O) Z 0-0 - 0 0 Ca c o o m co E -C o1. cap Ycc ~0M0O a) 0 C 0)o),_-0 -0 EU co a) o o U Y CD i m y _ Y T cn (D L d cti V MJ (n -0 a) a) - a) m ca a) Y O ~ co Q _ O v 0 M U p 0 -0 0) 3 U) (n (D cn W " O -0 a) C OL a) a> Q o z Ca Y N O O O O m -C 0- U 0) E 3 p 1. C U O i N C t c0 (n m go r Co go x ~ 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) LO 'ATION: SECTION: R pfd TOWNSHIP /M d+'At-f-TY: LOT NO.: BLK. NO.: SUBD V SION NAME• 4 4~1/4 (or .04 UNTY: WNER' /BU ER' AME: MA LING ADDRESS: 4 a USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: (PROFILE DESCRIPTIONS: PERCOLATION TESTS: Residence ? ❑ New Replace Il RATING: S= Site suitable for system U= Site unsuitable for system CONVEcNT[OWN L: MOUND: - IN-GROUND-PRES'SIURE: SYSTEM-IN-FILL HOLD IING TANK: RECOMMENDED SYto )4 _211L/ _V STEM:( optional) [~S ®S 0U J ~Y El J ©U OJ Zu fC If Percolation Tests are NOT require DESIG RATE I If an L y portion of the tested area is in the under s.H63.09(5)(b), indicate: ) S- Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTHt$I, OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B 9f ILI? B - / B B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER 4--ES AFTER SWELLING INTERVAL-MIN. PERIOD t PERIOD 2 PERIOD 3 PER INCH P- 3 P- r n P- 7 / 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 x . 40 E !-4 7-,f c I, the undersigned, hereby certify that the soifi tests re orte o this form ere made y me in accor 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. I "I NAME Trint : TESTS WERE COMPLETED ON: JJ . S S-- _ _ AD S CERTIFICATION NUMBER: PHONE NUMBER (optional): CST I, NNT RE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. ~r DILHR-SBD-6395 (R. 02/82) - OVER - ,,.t§"n waecF. $$°'LL S ,red %..~~r' ' ,,IAXIP,,ILAA tkt_7rnbk :r nr t' udrocmr S .r (,A! P Wff, Or svsfew~ "1. .r-;:.~..:.. !z, Is nwre'or vv ii~tcj ?7¢b ,rl~' Cle..,.f 3;..;~Ctoi~s and completing the, t~j~~f ~~l>~~.. r`,)I K E A t_C =13 r di ac „r,a ;.C , rat,fl y loca-Inc-, ~ of o?<J l43c_,C ns. Dra r: inn ro „gale is pr~E n tocj, r. i i. w 3 1, flE s;r 0;; i t - B5 S S _ C (Lit'tf9ei" T ) LS I'd VV H`qh Gluwtivvul, ~,l a d, Rate f 3_ rev 1 r r Sri', o'i„ - `affil r} fir; 0 ~i?'3 G y t - -i - S r ° aF 7 a f e C '='ay CC : _o ® ~ v L Ffigh v- PAGE OF C CruSS .J`c~►ur1 0 A e►7 JyS~c°n1 Fre►h Air Inlef► And Ob►ervallon Pipe Approved Vanl Cop Minimum 12" Abova Flnol Grade 20- 42" Above Pipe _ 4" Coal Iron To Final Grade Vanl Pipe Mar ah M0y Or Synlhelic Covering min 2" Aggragole - Ovar Plpe Dialrlbullon Pipe 0 0 0 0 0 - Tee - b" Aggiogole Beneolh Pipe ° Perforoled Pipe Below o ~-J-Covipllnq Terminaling Al Bollom Of Sy►Iem SOIL FILL DISTRIBLITi0V1 PIPE APPROVED S4MT--IETIC COVER u o "PIATERIAV OR 9" OF STRAW 2" OF AGGREGATE OR MARSW HAy ii ELEV. OF A~ / E6 0 1° OF 2 P'/Z AGGREGATE DIS-I"R119UTIOIJ PIPE T() BF AT LEAST [ IIJCHES BELOW ORIGWAL GRADE AQU AT LEAST20 I►JCHES BUT AIO MORE THPJJ '12 IMCHES BELOW FINAL C-RADE MAXIMUM DkPrH OF EXCAVATi(DIJ FKOMr OKIGrJA4 0mvk WILL BE I►JCHES MINIMUM QEP" OF E•XCAVATIOM FKOM'*G1WAL r7RAPE WILL BE INCHES LICEUSE IJUMBEF': DATE ~~S / Ila jild 114 zz- ze- 4e 70 4nl 7~ ~ i i IL- f !I I