Loading...
HomeMy WebLinkAbout040-1204-80-000 T r rr~~ o N O a d o m m -0a CD 'D a n p `C fly~~' • Cn ~j -i 2 n Z ° co c a) C N ° % 03 c O a) = N 1 ~ O N O o d o, `A, 7 w O p O a c ~p 03 a) U) N = O = O 00 O ( , _ 0- CD ~ O m _ P ° A7 C O O N O 7 N O ~ O C N Cn D (~n m CL CD ~ N ~ {y 0 z 3 C d i O N V o co co CD n o c rt t-i t-' cn cn » Q I- d, n o n N o z 00 ?CJ a) a cn N N v v v F...~ `..e. O f'D A N A (D' H ti' 9+ N ~ d N 3 N r ~ I Q N d z co z CD O ° Z CD (D (N CDo N U) Z v ~ C N C O rt 00 a 71 -i N ;fl P, 00 ~d - ;o n A Z O (D m ~O ti b G7 r o C1 W H rt m cn N cn G N• ' W o co Z ( H ~J o (D N) Z 0 CD Ln 3 3 m H N n o rD CL O T 3 ti c = z a o (D m CL o i ? ,sA A n 0 a N O O I A o b F N Op N < ft f» O o o o a Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER t~~zera-~° ° TOWNSHIP '11.1 - SEC. ~S T 2'R N-RZea W ADDRESS It 3 gaa14%1 ST. CROIX COUNTY, WISCONSIN SUBDIVISION KoxNi=Ew ACR&S LOT LOT SIZE A. C= `~•PLAN VIEW Distances and dimensions to meet requirements of ILH-R 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM z'"'1, i5e-o t 54 I N ~ J U' INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used G Elevation of vertical reference point: IS." Proposed slope at site: SEPTIC TANK: Manufacturer:-- Liquid Capacity: OLY-) 'j j9. 5~ tl Number of rings used: Tank manhole cover elevation: Tank Inlet Elevation: 42- Tank Outlet Elevation: Ste- feet Number of feet from nearest Road: Front 10 Side,Q Rear, O t feet From nearest property line Front,OSide,ORear,O E ~t i Number of feet from: well building: 1 -(.1- (Include this information of the above plot plan)( 2 reference dimensiE SIDE septic tank) SEE REVERS f 2 PUMP CHAMBER ~P 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, OSide, O Rear,(D Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: Width: Length: 5L -Ca" Number of Lines: Z.., Area Built: (oZ4. Fill depth to top of p pipe: Number of feet from nearest property line: Front, O Side O Rear, O Ft . OJa iCX Number of feet from well: L\XY.. W)G' Number of feet from building: ::5 Z (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diaineter7 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 BUREAU OF PLUMBING P.Ct. BOX 7969 MADISON, WI 53707 Number y CONVENTIONAL ❑ALTERNATIVE (State State if assigned) (If assigned) ❑ Holding Tank ❑ In-Ground Pressure El Mound 11 NAME OF PERMIT HOLDER ADDRESS OF PERMIT HOLDER: INSPEC ION DA q: 527 - 13th St., Hudson, WI 3 Lawrence Land CST REF. PT. ELEV. REF. PT. ELEV.: BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. SE NE,Section 25, T28N-R20W, Town of Troy, Lot#8, Plainview Acres Name of Plurn ber. MP/MPRSW No. County. Sanitary Permit Number. Paul R. Cudd 2739 St. Croix 69686 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV.'. TANK OUTLET ELEV. WARNING LABEL LOCKING COVER PROV ED: PROVIDED. p YES NO OYES [fNO ERTV WELL. BUILDING- VENT TO FRESH IFR OF BEDDING. VENT CIA VENT MATL. HIGH WATER TN MBER OF ROAD LINE ~{~.IR T LETALARM ET FROM Ir OYES O OYES NO AREST DOSING CHAMBER: MANUFACTURER BEDDING: LIQUID CAPACITY PUMP MODEL. PUMP/SIPHON MANUFACTURER PROVI LABEL PROVIDED COVER OYES ON Y NO OYES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF P OF RTV ELL IBUILDIIII, VENT TO FRESH INE AIR INLET. (DIFFERENCE BETWEEN FEET FROM PUMP ON AND OFF) OYES ONO NEAREST IEti(;T~I IA',IF I ER MAT RIAL AND MARKING SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: - LIQUID LEN TH NO. OF DISTR. PIPPEPACIN(, ('C7V EFy INSIDE DIA. SPITS DEPTH- TRENCHES MATEfiIAL. -PIT BED/TRENCs DIMENSIONS _ IPE MATERIALNO DI TH TPR PERTV WELLBUILDINGVENTTO FRESH (;R~~VF IICI'*li H UIS PF DISTRPIPE DISTR. P NUMBER OF I LINE AIR INLETBELfAwPIER ELEVINLEI ELEtiEND ~ PIPE FEET FROM C, NEAREST 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 ONO oBSERVATIONwELLs PERMANENT MARKERS. SOIL COVER rexnlRE OYES ONO OYES ONO SEEDED MULCHED DSODDED OYES DNO OYES ONO OYES ONO PRESSURIZED DISTRIBUTION SYSTEM: FILL DEPTH ABOVE COVER WIDTH LENGTH NO.OF LATERAL SPACING. GRAVEL DEPTH BELOW PIPE. BED/TRENCH TRENCHES DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR PIPE MANIFOLD MATERIAL: POEDISTR. DDiSAT R. PIPE DISTRIBUTION PIPE MATERIAL & MARKING. EI FV. ELEV. CIA. ELEV. ELEVATION AND DISTRIBUTION COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED INFORMATION FiOLE SIZE HOLE SPACING DRILLED CORRECTLY PLANS DYES ONO OYES ONO T MARKERS. OBSERVATION WELLS.NUMBER OF PROPERTY WELL. BUILDING: COMMENTS: PERMANEN FEET FROM LINE. OYES ONO OYES ONO NEAREST- Sketch System on xain..-inrqunty file for audit. Reverse Side. - TITLE SIGNATUg6^ DILHR SBD 6710 (R. 01/82) - - - ~ i wlsconsln APPLICATION FOR SANITARY PERMIT ®1LHR l,. (PLB 67) COUNTY OEPRR7MEnT OF UNIFORM SANITARY PERMIT # f"OUSTRY, - ~ OUSLRBOR6NUTRnRELRTlOnS 7 yj -Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8'/Zx 11 inches in size. -See reverse side for instructions for completing this application. PLEASE PRINT PROPERTY OWNER MAILING ADDRESS Lawrence Land 527-13th St . , Hudson, Z! 54016 PROPERTY LOCATION XKfXX `AIKAYG`L1 Troy 5 5 1/4 . 1/4, S 25 , T23, N, R 2113 ate) W TOWN OF: LOT NUMBER BLOCK NUMBER SUBDIVISION NAME r REST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER 'lai iview acres jel finder Jrive TYPE OF BUILDING OR USE SERVED Q~a - laG 7 1 or 2 Family Number of Bedrooms: ❑ Public THIS PERMIT IS FOR A: X 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. aJ 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 1-000 T - Lift Pump Tank/Siphon Chamber Holding Tank capacity manufacturer: 11eSP1 Concrete s t'Irl Ct 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): Class 1 615 c:~, -k;' Q 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): na re: MP/MPRSW No.: Phone Number: Paul R . ISudd 5 j27:: ~ ;c (710425-9`1. Plumber's Address: Name of Designer: Rt. 5,o 36~, fiver FaJ.I ; I 5.~o2z art serer (.576) COUNTY/ DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: ❑ Disapproved 75 f y ❑ 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. Pu z to - t i.; .1i) Luca Lion of Prop c-rry _pv C_`"k... aucticn_ T N tt, W `t'ownrah1,p____-- S?.rbdivijion Na;anra ' * td m b to ~ I"r'Qa~ icaswb fvaraer of .1'rope ar:Y li,:L 'Pocr.1 Size oi Marcel U6a:e Paa<rcel. Wan GreLit ed ' foil )wil1 Dee;? is t r r, r C o f ta..* g ,til. tb0Csale11L wlaicit deuc,riey tfte E- iuperty PRUERTY OWNER CERTIFICATION ti SHbe) certify that all st.aatements on this torm are true to th'e breast of my (our) knowledgaa that I (wit) +.1m (are) the owner(s) of the property de&cribed in t, information forma, by viftue of a warranty deed recorded, in the Office of the (..~-wnty HjUistur of Deeds ds Gocumant No. and that I (we) presently dawn the prop,eoa d site for the saawige dmPo;l,,;al system (or I (we) have obtainud an oddment, ter r.~n with thu atx3ve described property, for the con.itruction of said system, and the mama ha:- been duly recorded in of the 0junty t qister of Deeds, as Document No. ) SIGI vAYUra OF 4'rr-G~rW:'NL ('1-- } .:.f'i.HLt; DATr SISlt-ptio DAATE SaEdc&C) t k x - MAP CERTIFIED SURVEY T28N,R20W, LOCATED IN THE NE 114 OF THE NE I/4 OF SECTION 25, TOWN OF TROY, ST CROIX COUNTY , WISCONSIIN. OWDNE DRBY: DELANDER RT. 3 PLAINVtEW DR. S-E SHEET 2 OF 2 FOR DESCRIPTION.- RIVER FALLS,WI 54022 0 SET I"X 24" IPON PIPE WEIGHING 1.13 LBS.PER LINEAL FOOT. b- I" IRON PIPE FOUND. 2" IRON PIPE FOUND. SCALE I"= 200' 0' 100' 200 400 N 1/4 CORNER SECTION 25, NE CORNER SECTION T28N,R20W• (COUNTY SUR- 25,T28N,R20W• VEY MONUMENT FOUND.) NORTH LINE OF THE NE I/4- (COPNTY SURVEY MON- UMENT FOUND.) 87° 07 46"E 1728.02 ~Z ~ S 87007'46"E 379.01 S• N87°0746'W, w r S', w w 378.9T' 549.01 w N8T°07'46"W w I W w 0 33' 33'1 I ~z N O O i• O~1 UNPLATTED z A`-m I C 0 .r_:~ m2D 0 m -4 r 00~ LANDS LOT I A,D •1n•.~~ o=~ rfj I °f 10.967 ACRES W 0 m 477, 727 So. FT.) s. :~D n m m 10. 68 AC. TO R.O.W. p ( 465,220 So.FT.) lo ° A - EXISTING :U A m HOUSE 0D I :-L; m m m m f` 00 I •'U o m Z U) z I _ o n m ~I Tr T} o ..-~JUJJ , _ p IV •f ~e S87°07'46"E 400.00' m W O1_~'o z D SHED w 1 -1 •(n N 87°07'46"W 430.00' 33'i U _ 133 m C7 z UNPLATT•ED ° cn LANDS z _ o D m ~ee:dede JPP't Vi Q~ 4 ;lop z o a l( INC 1•' \ SPRG VALLEY l VJIS i iN87°07'46"W 347.39' I . rr C 41 FENCE LINE _ I e,c,,CP~ 1~G44bQo U N P L A T T E D s!1 k I t • •X• WESTERLY LINE OF I ~PLAINVIEW ACRES. ,Ja~.QQ JAMES M. WEBER S-1804. L A N DS f WEGERER,WEBER AND ASSOC. RIVER FALLS,WIS. I SHEET I OF 2. 7HISI INSTRUMENT DRAFTED BYJ'e11'=• 84-97 P CERTIFIED SURVEY MAP LOCATED IN THE NE I/4 OF THE NE 1/4 OF SECTION 25,T28N,R20W, TOWN OF TROY, ST. CROIX COUNTY, WISCONSIN. OWNED BY: Virgil and Patricia De-ander R t. 3 Plainview Drive F _ River Falls, 'v: i 51.022 5_`i, SHEET DESCRIPTION: I, James M. Weber, registered land surveyor, hereby certify: That in full compliance with the provisions of Chapter 236.34 of the Wisconsin Statutes and the provisions of the St. Croix County Subdivision Ordinance, and under the direction of Virgil and Patricia Delander, owners of said land, I have surveyed, divided, and mapped said parcel of land, that such plat correctly represents all exterior bound- aries and the subdivision of the land surveyed; and that this land is located in the N% of the NE4 of Section 25, T28N, R20W, Town of Troy, St. Croix County, Wisconsin, to-wit: Commencing at the NE corner of said section 25; Thence N870 07'461V along the Forth line of the NE4 of said section a distance of 549.01' to the point of beginning: Thence S1 °41' 4511W along the westerly line of Delander Drive 768.001; thence Iv870 07'46"W 430.00'; whence S1041 '45"W a distance of 437.00' to the SW corner of Lot 8 of the plat of Plainview Acres; thence N870 07'46"W 347.39' to a point on the West 'Line of the NE4 of the NE-4' of said section 25; thence-NI °37'07"E along said line 525.03'; thence S870 07'4611E 400.00'; thence N1 °37' 07"E a distance of 680.00' to a point on the ?north line of the NE4 of said section 25; thence S870 0714611E along said line 379.01' to the point of beginning. Contains 10.967 acres of land subject to Plainview Drive right-of-way over the northerly 33' thereof. Also subject to any and all easements, right-of-ways or conveyances of record. Dated this ZSZ~ day of _,1985. James M. Weber S-1804 Wegerer, Weber and Assoc.,Inc. ` M0lvs ~ A River Falls, WI ire 4Z JAMES M. WEBER t S - 1804 SPRING VALLEY I J~ Wis. SHEET 2 OF 2. y ~e g 41 SUB D~iri~L~ii►V`' THIS INSTRUMENT DRAFTED 84-97 - ' r7 3 C - 1.0 5 S F!', P' )WNE i ")UTE/BOX NUMBER Fire Number r CITY/STATE t t• _l._l_5 _ r..._ . l .s J- - - I i' ! t l__ _ - I ` - P 'v Ja Jy}~ W Sect-ion i 'T'own of_ i_0 L1, T St . Croix County, i 5. G c:s cl iv i. . i, t: Lot n u m b e r - - f i 1mi.)roper u~sc and snaa.n-tenance of yjiiE:- septic s _;tem ca~Jld result in its premature failure to handle i.aastes. Proper i-uai.rntenance c.o i-- slls,t:s of pumping out the septic tank every three years or sooner, Lf needed, by a licensed septic tank pumper. What you ;)ut into .a system can affect the function of the septic tank as a treat- ment stage in toe waste disposal system. t.. Croix.County residents may be. eligible to receive a grant for a iaxirnurri of 60% of the cost of replacement of a. failing system, whic''n was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1988, with the requirement tLat. own2r..s of al. :t- new sy_stems agree to keep their systems prope.ri y 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 ver:i.- fying that (1) the on--sit:e wastewater disposal. syst.ery is in propu- operating condition and (2) after inspection and pumping (if nec-- essary), the septic 'tank is 1-es than 1/3 full. of sludge and scurc . Certification form will be sent approximately 30 days prior to three year expiration. y I./WE, she undersigned, have read tti,> above aega.iirements and agree Y, Lo maintain the private sewage d1spo3ai system in accordance with the standards ;et forth, herein, a set by the Wisconsic-i Depart- TRe11t of Natural Resr_)urc.e + er.t iCication form, Must be completed and returned to the St. Croix Co.u i _-y Zoning Of f i_t-e within 30 day:; of the three year expiration datF, SiCINED t ri _ I f St. Croix County Zoning Office P.O. Box pia I Hammond, WE 5401.5 ~ 71.5-796-22351 or 713-425-8363 Si. 3n, date and return to above z.,d0res's. v_ N ~m x ~ U) c ^'30 p ~ cn w ~ O m~~ O O ~ mmam 'cam==!w~ N 3 ~ o ° Qo cowwu,~l c_ ? co =3 3 c co cn o Mo Z 7 0? O a m m O CD "1131 CD C dt O C A W oo pOp N A D N C O N ;17* N w w A S 51 r w = m O = (SD OOD A co A 3 a O o m Y o w (0o M w~ O Sy_ ° o = c° w w p p c p N 3-»c oc3oao ~ ZO C `G Q O w_ 9 ; w D~ U1 cn - M OC=,r O p a m 7 _ Q ~ wC, mm~ (on> A A O "N'► O A w c =r ~3 c O O m a 0 ' w o aQ° w a N It oF)M '(=D~4►w(n Z m v, m $ m' U) Nan 0 Z Mr S, W CD (D~ A ?gym o am 0 3~ N M N a C) wEr as Er =r 0 s0w° 0. =r Cl. 43 C two a c M v 3 m v m~" 7 o mc=r O_am Cn 0 X10 'ate wMC=DU _ O m O CD m N cn ° C c cp =0 0 ° WD 3a c0- cfw M cn c c a w O 0.0 * wow m -amW a a vi o- O a Q M r« ElF to O G) co vi `.ZD A m O 7 0.o = c~ w -Im c m s a 5 0 o =r c N p! p A0 a°3 0 3 a m ai' 0 3 ° a o ~R € M CO) o C o r 'a DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) P.O. BOX 7969 HUMAN RELATIONS 1 / MADISON, WI 53707 (1-163.090) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.: BLK. NO.: SUBDIVISION NAME: '/a '/a 2,5 /TAN/R2dE(o -7,PGy COUNTY:. OWNER'S/BUYER'S NAME: MAILING ADDRESS: 44AW 3-27 13 --41 5/ e_)v;~f 0 6v USE NO, BEDRMS.: COMMERCIAL DESCRIPTION: DATES OBSERVATIONS MADE esidence PROFILE DESCRIPTIONS: PERCOLATION TESTS: ~3 New ❑ Replace RATING: S= Site suitable for system U= Site unsuitable for system sc S CONVENTIONAL: MOUND: IIV-GROUND PRESSURE: SYSTEM-IN-FILL HOLDING TA/N✓WRECO-IMIMENDED SYS TEM:(otional) ©s ❑u s ❑u a s Zu e~~1J✓DfJq If Percolation Tests are NOT required DESIGN RATE: If any portion the tested area is the under s.H63.09(5) (b), indicate: Floodplain, indicate Floodplain elevation: rT PROFILE DESCRIPTIONS BORING TOTAI DEPTH TO GROUNDWATER-IN CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) i B © -e I mss. B IS4) -6 f/. 54 67 'AO S - lA,c, L5 w 7AAJ 11 C 71y- > ' S '/s'u y. 5'y, / J tl/,u 5i 33 74v 1/~ccf c B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL -IPJCH ES NUMBER IN Fr AFTERSWELLING INTERVAL-MIN. RATE MINUTES PERIOD 1 PERIOD 2 PERIOD 3 PER INCH P- 3,0i 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. E~ / '~9CT~ y SYSTEM ELEVATION 74 6 Arm J V191- Ed,, 4. W f s` E r - - _ a_ ~ H i E E _I z T i E E i - E 3 1, 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 (print): TESTS WERE COMPLETED ON: momr9 14U 6-,e -r ADDRESS: RT-A 3'NEIL rtOAD CERTIFICATION rNUMBER: PHONE NUMBER (optional): CST SIGNATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - MPYW mgm tam tow: IM {t 1 li1't.LIL1 isz.[u"i :3eC of dr( O n"'. or C£:)et7r riC':?l use .=f'. cC rnrlr Hdlg it ? i1' si€' q bf :s. A SITE iS aU, A T E I,,I k fE I) C),iT s SF 0tt» S _111 D 1 T 1 e! ~JS l,, t, 1, " . 1 . f., . i 'S c , 1 r'o „te t.1escH~}1.uwn and (,{„~~~~.~1E~'. bnq 3t; . . .-t J l z J`.agr 1 ~)CC kIAO!'S = nai , ywr WA ioca io ns. i 'b'ring to scat i3 [w son! if i u 1t£ isi r ye?Zje- one tome ,n ,r thi r i r Tn w poS 'rn cle"Fly ,°hL1v m"aand aie r r K c 0 d:, ,n aF p ,.°ne._,,.,thon t£... P~ it c,:=ltis{ ¢ a r}e,. ti`s{>is, aCtbJit xCi es sin-''.i 7 Sign the Rurn and place YOLU C31neoF MW WK YWW OWN' St = s 3 uY 06ir7 L.` IOn S s qh _ (Name SWA Pe, i c";' E Low- SO Loam My L t Sandy §'i z F! %Kv My Low-, -lot WtHy~ s? w ) ON f Pie font t4 t c- mm t Ninny, i n € t. mn i;? _ s, teems," 6t, the 101 00-P in securing a v1_x y Cif rmn. Lite co t,Lv r;Ct so-: sLFf,=,. win s°7ay request s41.FS? Is a5.o-`s i7i this W lot in i ',rs ~ P101 t x - s ,s?-gF E - p"We ?jc ''yst(+., -_;d a 6 a`m a rs1Jj ..c"E i.- , trin;. s 10 s, .p.r 3, ,s Kw o fEt mn- y 91 MAY U) REPORT ON SOIL BORIN&S PERCOLATION TESTS 115 ' PLO -r P L,y M PROTECT s. D. HOME-SiTE TESTING CO. PT.3, VMEaL ROAD BOB "UsONt WIS. 5,4016 C57- SS- a2 Y-eZ PRoPo5 D moo$E most LIB 2~ ~r O ~lOr~E ~iQOM iyLL rs~3r f3,+PE~~. P PoSE D WELL M VST L! 50 TrsT o = SAcellDE Pli '3 O = EXIST) V 6- ~CJELL X = pEQG loC~1L4~t/f = #,4.vP ilo ,r~040 o ,,e S~~s EL /.34eE5 s a horiz . m VERrICAL .PEFERt.vc~- Poi r' Tc,~' G,cf~,y U~',~' T /Pty ~ r L0T" Il Ca p LE GEN Z-1-14i ZEE- Yoko /©Q w T . /V a,2 r Ga r Gi r a~ ( s 51 E-'Al X2.4 J J L +S X L ~ ~C 1 36 P4 &5 sd~p~s ~ SLopEf 0 I-oc 30 v/Ao~~ ~ I J . k 1 r 9 } ' f 6 GP-ADE =1NIS4?~ n~X1riUF' - yZ z" OF AGGREG TE SOIL FILL DIS I RIBUTIO►U PIPE 1 j1PPRGVED SUI.;THE 71C CO.' 'MhT E RI:,L OF, OF S ~ R:, OF, MARSH HA.t1o OFGGREGATE OF DISTRIRUTIOIJ PIPE Tp BE AT LEAST Zy IUCHE5 BELOW ORIGI►JAL GRADE AU-- AT LEAST ZO ItJCHEE BUT UO /,'IoRC THAM '-i2 TUCHES BELOW FIr,AAL &F P,DE *%O=!^^,`J^', DLP-! H DV LXCAV),TiC1., FROtl, ORIGWAL GRADE 4JILL 6E IUCHE5 ,^^„t."MUM DEPT H OF EXCAV.t,T)CiJ FROM, ORI ;IUAL GRADE WILL -rE Imc E:S f c~ `i63 .0 j PLOT PLAN f Lccation of building served Q Dosing cha.'_,2r I ✓ Verticai/hOrizor,t_al reference Septic tank Building sewer ✓ System eleva-Lion, is `1z -7~ I_ - Sf fluent system l y i Well Replacement system area !A Precerty lines w/in 50' of Sys- ~'v ?-3;q Distribution ]DOX25 ✓i Scale or dimensic. - r, & Model No. Vertical Lift Size orCe in D. Vol. Oist. P Gal. per IM in Gal. per Cvcle Piace cnec- mark in appropriate box, indicating item is s'loGln on plot plan be1Ow: WALL ~o PT l ST Soy 7ri SST '~F 1►.~~Tl R ~ ~ C'r~t~-r1CQ~4~T 5`ts 7~'7S. SEP~ r, TthJK ~ `l L I r 4 ~ - 3° o G S ~ r_ $z yu PV` ~I 't I f P 3 I6~ 31 s ZP~o hzA J 7 83 N I ~ U) ` I y'r p v c ~R FORtt-r~D t I i Paa✓E ~J R~bll'~o+-~~~ Ph~L S 4C, vE" j _ , yv f f LoT a "Z)I\.R Vj PIPE 1 ~ { B/ P l-A i u V~ Ek; H C~-~ S s as 1 r` I By the grant_ng or approving of the above clan, or upon the event of a subsequ: it permit seine issued,Z'.^roi_.(-conty ar,d t:e5t. ty Zoning Administrator, 3oes not assume or hold i tse lr l F ia a = rn-anl- or s7j-2clficallons, plan bl e for any _ - omiscion, examination ov •rsigh;., construction, or that may result in or after ins,allation. 7 _ -2 , l . -7, T - - - - l e Parcel 040-1204-80-000 10/18/2006 09:30 AM PAGE 1 OF 1 Alt. Parcel 25.28.20.954 040 - TOWN OF TROY 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 CINDY L & ROBERT W HARWELL O - HARWELL, CINDY L & ROBERT W 182 DELANDER DR RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 182 DELANDER DR SC 4893 RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 7.480 Plat: 2332-PLAINVIEW ACRES SEC 25 T28N R20W 7.48AC PLAINVIEW ACRES Block/Condo Bldg: LOT 08 LOT 8 ALSO KNOWN AS THAT PART OF LOT 3 CSM 6/1777 INCLUDES P621E Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 25-28N-20W Notes: Parcel History: Date Doc # Vol/Page Type 03/21/2003 714119 2179/254 QC 10/29/1997 567612 1273/219 WD 917/223 908/360 more... 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/22/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 7.480 68,900 209,700 278,600 NO Totals for 2006: General Property 7.480 68,900 209,700 278,600 Woodland 0.000 0 0 Totals for 2005: General Property 7.480 68,900 209,700 278,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 214 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00