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HomeMy WebLinkAbout020-1158-70-000 0 c 10 o d `r1 C 3 3 "0 3 (D T. I OJ fD 3 ~ a~ 0 Da 0 a, o o cn (n c o h O N (SD 3 m ca 00 W C2 Z C) N = ' O '.Z N N N C m CD o 7 Vt (D W N 00 N N O- 'O O S O CO J o W G H OOD 0 o 0 0 ro c a o O S r3 Ly v Cn N CL O O (CD d o U) 3 Co ° ° o ut ~ cn ~ O D d r7 ~ ~ cu U) ~ D M a m O F-'• O H N n N a Q rt H N C c o W ° E3 ~o Ul i O N 1 N O 0 CL z `o N' -co I C~ r to (_n CD z 0 0 0 - D ! c o Cn r M. titiy CD v rn m rn s(D moo (D m v o Q - N <D v V 3 fD a' N tai' Z .r N A O rt O U) :3 CD 0 r I 0 O ; a T o m v 10 ~E Id o cn m CD N c lij n (D 7y AD Q4 Hl r 5 ~D N N s W N H ri Fy ! a O P CD t C Z cn t -i en .p. Z 0 F• (D O o w p I-h _ t C o. (D C)- (D -I N U) cn 0 W * ~ o (D m CL z 3 C ~ z O 3 m N z CD A W _d CL rn o' - CY nci c c - = z a m CD C) _S N 1 A V A S fi O ! N O ~ O ! A ~ ! w O_ CD DO ff3 O ~yy 0 :E O O V _Parcel 020-1158-70-000 01/07/2005 03:43 PM PAGE 1 OF 1 Alt. Parcel 20.29.19.894 020 - TOWN OF HUDSON Current X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner LINDA J STADLER ' STADLER, LINDA J 835 MAUD RD HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): = Primary Type Dist # Description * 835 MAUD RD SC 2611 SCH D OF HUDSON SP 1700 W ITC Legal Description: Acres: 1.510 Plat: 2329-PINEGROVE HEIGHTS ADD SEC 20 T29N R19W PINEGROVE HEIGHTS ADD Block/Condo Bldg: LOT 01 LOT 1 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 20-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 957/333 07/23/1997 891/296 07/23/1997 864/542 07/23/1997 864/417 2004 SUMMARY Bill Fair Market Value: Assessed with: 48977 156,000 Valuations: Last Changed: 10/26/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.510 25,100 95,600 120,700 NO Totals for 2004: General Property 1.510 25,100 95,600 120,700 Woodland 0.000 0 0 Totals for 2003: General Property 1.510 25,100 95,600 120,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 121 Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 27.00 Special Assessments Special Charges Delinquent Charges Total 27.00 0.00 0.00 ST. CROIX COUNTY ZONING OFFICE St. Croix County Courthouse AY V 911 4th Street U r Hudson, WI 54016 , Telephone - (715)386-4680 The St. Croix County Zoning Office offers the service of septic and water inspections to Lending Institutions, Realty Firms, and private individuals. Completion of this form is essential so that the property can be located. Please provide the following information, enclose appropriate fee made payable to St. Croix County Zoning Office, and mail, along with form to the above address. Testing will be done as soon as possible after fee and form are received. WATER TESTING----------------------------FEE: $ 35.00 (For nitrates and coliform bacteria) WATER TESTING FEE: $185.00 c~ (For VOC S ) ~r7- CJ SEPTIC SYSTEM INSPECTION-----------------FEE: $25.00 (Determines if system is properly functioning at time of inspection) PROPERTY OWNER'S NAME : Aet 1%i I ~l PROP. ADDRESS: 3 /_1,4&fO R CITY Legal Description 1/4 of the 1/4 of Section , T N-R Town offs Lot Number Subdivision: FIRE NUMBER LOCK BOX NUMBER Color of hogo Realty sign by house? /-/0_If so, list firm: PLEASE INCLUDE, IF AT ALL POSSIBLE, A MAP,i.e,COPY OF PLAT BOOK, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Testing of residential water requires a sample that is fresh. If the home is vacant, and has been so for some time, the water line must be purged by running the water for several hours before the test can be conducted. WINTER TESTING: Many times water lines are turned off, or sill cocks are turned off, making access to the home necessary. If this is the case, please make proper arrangements with this office to ensure time when entry may be gained. Firm or individual requesting services: f0 yW r-4-'-5 Telephone Number / _ - 3 '-6 _ REPORT TO BE SENT TO: A -F-,-41-7Y S-0 C/ CLOSING DATE: - Signature ST. CROIX COUNTY WISCONSIN ZONING OFFICE 11 e a . y C; F-~. ST. CROIX COUNTY COURTHOUSE W&# 911 FOURTH STREET • HUDSON, WI 54016 7 (715) 386-4680 May 12, 1992 ,P. Yuengst 'Realty Worlde = St. Croix Realty 509 - 2nd St. Hudson, WI 54016 Dear Mr. Yuengst: An inspection of the septic system on the property of Sam Miller, located at 835 Maud Rd., Hudson, WI was conducted on May 12, 1992. At the time of inspection, the sanitary system appeared to be functioning properly. The inspection of this sewage disposal system was based upon a surface inspection of said system, and did not involve any excavating or chemical analysis. Accordingly, there is the possibility of hidden defects in the system not discoverable by this inspection. This does not in any way warrant or guarantee the continued proper functioning or operation of this system. It is recommended that the system should be pumped once every three years. Therefore, the prolonged life of this system may be dependent upon proper maintenance of the system. Sincerely,; Mari J . ;h&nkins Assistant Zoning Administrator cj AAA Y74ju, Form- S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER A//f TOWNSHIP SEC.2 T ~N-R / W ADDRESS 3 ST. CROIX COUNTY, WISCONSIN 3e~- SUBDIVISION QUQ LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of Il 63 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM tii up oep • po(A; >E,2 l~bx ys 4o cEA) TER 0 £4 ST Lor b LiiuE y6 f ~o o~ i5 3g 93 L FXisr~~S ~E// INDICATE NORTH ARROW SW- CC IenJ-&L BENCHMARK: Describe the vertical reference point used PoLOI. ,6 0 X Elevation of vertical reference point: Proposed slope at site: d ~o SEPTIC TANK: Manufacturer: Liquid Capacity: Number of rings used: 7 rr eL ' OTi'~" Tank manhole cover elevation: Tank Inlet Elevation: ! -(P2 -/Tank Outlet Elevation: 1 J S Number of feet from nearest Road: Front,@ Side 0 Rear, O / feet From nearest property line Front,O Side,O Rear, O - rb feet Number of feet from: well building: (Include this information of the above plot plan)( 2 reference dimensions to septic tank) +v + PUMP CHAMBER Manufacturer: Liquid Capacit Pump Model: Pump/Siphon Man cturer: _ Pump Size Elevation of inlet. Bottom of tank elevation: Pump off switch elevati Gallons per cycle: Alarm Manufactur Alarm Switch Type: _ Number of et from nearest property line: Front, CSide, O Rear, 0 Ft. Number of feet from well: _ Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: ^P3 Width: / d Length: JlD Number of Lines: -3 Area Built: 1~1- ~r Fill depth to top of pipe: ` Number of feet from nearest property line: Front, O Side, © Rear, O Ft Z- ~7 ~ Number of feet from well: 13 / Number of feet from building: F2- (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: er: Liquid depth: Botto seepage pit elevation: Area Built: Has either a dro ox O or distribution box O been sed on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: Capacity: Number of rings used: Eleva 'on of bottom of tank: Elevates of inlet: Number of feet from nearest property line: Fron Side, O Rear, O Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: RT. 3 O'NEIL RD., HUDSON: WIS. 54016 Dated: Plumber on job: ROB R LIC. No, 3307 M.P.RS. LER &D SIGNEkic. N0006 3 License Number MINN. INSTAL : 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOO 7969 MADISON,WI 53707 BUREAU OF PLUMBING MUCINVENTIONAL ❑ALTERNATIVE State Plan lI.D. Number, ❑ Holding Tank 1:1 In-Ground Pressure ❑ Mound (Ira-9neu NAME OF PERMIT HOLDER . ADDH ESS OF PERMIT HOLDER'. INSPECTION A Richard Stout k. R. 3, Box 340, Bass Lake, Hudson, WI APO- BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN REF. PT. ELEV.. CST REF PT, ELEV. NE SW, Sec.20, T29N-R19W, Town of Hudson,Lof#I,Pinegrove Acres Na- of Plumber. MP/MPRSW No Counry Sanitary Permit Number_ Robert Ulbricht 3307 St. Croix 54951 SEPTIC TANK/HOLDING TAN MANUFACTURER. n I LIO ID CAPACI.TX. TANK INLET ELEV.. TANK OUTLET ELEV.. WG LABEL LOCKI G CPE J" ED PRd. ES LINO S 111NO BEDDING'. VENT DI A.. VENT ATL. HIGH WATER NUMBE OF ROAD: JPROPERTY [VELL,. BUILDING. ~V NT O FRESH ALARM 4 FEET FROM LINE AIR INLET DYES LINO l DYES LINO NEAREST 1 Ifs -~LJ DOSING CHAMBER: MANUFACTURER BLIOUID CAPACITY PUMP MODEL. PU / PHON MANUFAC I ER JWARNING LABEL LOCKING COVER PROVIDEDPROVIDEDNO DYES LINO DYES LINO GALLONS PER CYCLE: PUMP AND CONTROLS OPERAT AL. LIMB FR OPEHTY WELL BILDING VENT TO FRESH (DIFFERENCE BETWEEN FE F FF_~ LINE AIRINLET PUMP ON AND OFF) DYES NO NEARE SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plo in F1,c,T11 DIAMETER MATERIAL AND MARKING E or excavation. (If soil can be rolled into a wire, construction shall cease it e1N the soil is dry enough to continue.) CONVENTIONAL SYSTEM: WIDTH. LENGTH. NO. OF IDISTR PIP SP CIN(, COVER INSIDE DIA. -PITS LIQUID BED/TRENCH ! L' TRENCHES MA4E IAL PIT DEPTH DIMENSIONS GRAVEL. DEPTH FILL DEPTH DISTR. IPF DISTR. PIPE DISTR. PIPE MATERIAL'. NO DI$T NUMBER OF PROPERTY WELL. BUILDING. VENT TO FRESH PROPERTY BE LOW PIPE' ABO VER ELEV INLET ELEV. END. PIP S ' FEET FROM !1 -7 2 AIR INLET. _7 J I `NEARESTs j MOUND SYSTEM: L~ Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- DYES LINO meets the criteria for medium sand. TIONS MEASURED. SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS DYES LINO DYES LINO DEPTH OVER TRENCH BED DEPTH OVER TRENCH;BED UEPTH OF TOPSOIL SODDED SEEDED MULCHED CENTER EDGES DYES LINO DYES LINO DYES LINO PRESSURIZED DISTRIBUTION SYSTEM: 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. JNO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING ELEV.. ELEV.. DIA. ELEV.' PIPES DIA.. ELEVATION AND DISTRIBU110N INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS DYES LINO DYES LINO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY JIVELL: BUILDING. FEET FROM LINE C- ( DYES LINO DYES LINO NEAREST-~ v'__\ r Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE. TITLE. DILHR SBD 6710 (R. 01/82) i Eino cgnslnAPPLICATION FOR SANITARY PERMIT DILHR S71' COUNTY (PLB 67) UNIFORM SANITARY PERMIT # I nT O u STRV, L!160R 6 "umRn RELRTIOn5 ,5•y 9s ~ -Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8'hx 11 inches in size. -See reverse side for instructions for completing this application. PLEASE PRINT PROPERTY OWNE~i MAILING ADDRESS ! 2~ J G'(^Aj S-f ,C~~{SS Lr1~E ; ~-t 3 ~DX '7/0 PROPERTY LOCATION CITY: G /V 1/4 Sw1/4, S Zo , T1 N, R 1 I E (or O TOWN OF: LOT NUMBER BLOCK NUMBER SUBDIVISION NAME NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER `tlae- 6-Po e ff E-(6-k-rS M,tVD PD TYPE OF BUILDING OR USE SERVED ~v J 1 or 2 Family Number of Bedrooms: ❑ Public (Specify: 3 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. b 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 4 /A, Holding Tank capacity Manufacturer: S CdA Q % /KQ A) / 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): PROPOSrl (Square Feet): / r Z (3 0/5 67 ~X3 6 ) Private Ell Joint El Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of PlumW4MTt)SEPTIC PLUMBING CO. Signatur /MPRSW No.: Phone Number: p RT. 3 O'NEIL RD.. HUDSON. WI S. 3 0 (715- ) 3J06- Plumber's Address: ROBERT ULBRICHT Name of Designer: WIS. MASTER PLUMBER LIC. NO, 3307 M.P.R.S. COUNTY/ DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: ❑ Disapproved Y ❑ Owner Given Initial V/11, I Z1TG•G~ / ` 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. ~74 HOMESITE SEPTIC PLUMBING CO. 4> RT. 3 O'NEIL RD.; HUDSON. WIS. 54016 ROBERT ULBRICHT WIS. MASTER PLUMBER LIC. NO. 3307 M.P.R.S. APPLICATION FOR SANITARY PERMIT MINN. INSTALLER & DESIGNER LIC. NO. 00663 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 douse"), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - (?caner of Property -DtC S'Too T` Location of Property NN 54) Section Z0 , T N - R W 9- Township //Ul0,S0 J Mailing Address 9, Subdivision Name Lot Number Previous Owner of Property Total Size of Parcel Date Parcel was Created 9~ Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes No Volume and Page Number 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. PROPERTV OWNER CERTIFICATION I (Ole) eenti6y that aU statements on this 6oAm ahe true to the best o6 my (ouA) knowledge; that 1 (we) am (aJte) the owneh(,5) o6 the pAopeAty daehibed in thi,s cnAonmati.on Gahm, by viAtue of a wantcanty deed neeonded in the 066ice o~ the County Regis,telc o4 Deeds as Document No. ; and that I (we) phensentty own the preopotsed site 6oA the sewage pos by6tem (oA I (we) have obtained an easement, to Aun with the above descAibed p)Lopelety, 4oA the eo"tAuction o6 said system, and the same has been duly AeeoAded in the 066ice o6 the County Regis teA of Deeds, as Document No. ) SIGNATURE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED 1-1 HOMESITE SEPTIC PLUMBING CO. S T C - 105 RT. 3 O'NEIL RD., HUDSON; WIS. 54016 ROBERT ULBRICHT r WIS. MASTER PLUMBER LIC. NO. 3307 M.P.R.S. y SEPTIC TANK MAINTENANCE A C R E E M AqN' INSTALLER & DESIGNER LIC. NO. 00663 H 0 St. Croix County z OWN ER /AH i R ' bU I y ROUTE/BOX NUMBER 3 3y0 Fire Number CITY/STATE yo,/- ZIP PkOPERTY LOCATION: A)~ S~ Section ~d T ~N, R W, Town of ~4V D So D St. Croix County, Subdivision P(~s G "-'OL~LX- Lot number_ I f4 E'64, TS • 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 pumEer. 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 n(,w sY~'tenirs agree to keep their systems pl oprrl y maintained. The property owner agrees to submit to St. Croix County Zoniu~; 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. CD z I/WE, the undersigned, have read the above requirements and agree N to maintain the private sewage disposal system in accordance with aq the standards set forth, herein, as set by the Wisconsin Depart- b 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 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 iii uwscoltisr~ SANITARY PERMIT County I~Y-DILHR .,..0r11ror GROUNDWATER SURCHARGE .....~,.,a.r, r'rx,ffiYp.,•..A.IC~~....,,a,A.....T,17/,. Sanitary Permit No. On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more com- monly known as the groundwater protection law. This change in statutes was the result of over 2 years of steady negotiation and public debate. The groundwater bill included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that is used in your building is returned to the groundwater through your soil absorption system or the disposal site used by your holding ?ank pumper. The monies collected through these surcharges are credited to the groundwater fund adminis- tered by the Department of Natural Resources. These funds are used for monitoring ground- water, groundwater contamination investigations and establishment of standards. Groundwater, it's worth protecting. Groundtet' Signature of Issuing Agent: Groundwater Fee: Date: WISCO sin's l 41 buried troasuro DILNR SBD-7289 (N. 05/84) e r dE°ARTMRNT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION 1 P.O. BOX 7969 LABOR R RELATION'S ELATION'S PERCOLATION TESTS (115) MADISON, WI 53707 (H63.09(1) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOTNO.:BLK.NO.:SUBDIVISIONNAME- I)a,P40iV k 1/4 1/ 2-o /Tlq N/R(q E (or H1)P--spy / 2,;[,. S7007- -a~~ COUNTY:. OWNER'S/BUYER'S NAME: MAILING ADDRESS: H0PTC u 6t -6 9 o w ri ,400 13,0x a. l Z ,,',p'jrrj., Gv'. A."; s s ycv(c: USE DATES OBSERVATIONS MADE : PERCOLATION TESTS: NOT7 OMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS I Residence New ❑Replace RATING: S= Site suitable for system U= Site unsuitable for system _ NS ENTIONA,L:MOOUUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) 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: PROFILE DESCRIPTIONS /3Ueklc.a,a7-- BORING TOTAL DEPTH TO GROUNDWATER-. - CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) /.a' I3,u-6y. s,L, &7` L-1 N-5''I- .~7aA) •C:5 4-yk 73 B- 13"' 7f B- 2 -C! r. 7y ' aN 6s 51-, . ' ZI V . S, /0.0 ' TAAJ B-,3 0` /a a. G C 75r B-~ d •S ; ~t3~ ;~..6c sue, . ~3' ate. 7~. s, ~.603 ' 7-4A" B- f 4j PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD 3 PER INCH P- YO i o w Sir /-u I. P- a v ergs. E p- Z P_ / L S - oc,~~Te . 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. 64le-1-1V /'Q, FT• ~ SYSTEM ELEVATION E 3i' l E I 3 E ` ~ a E i t N e ; I E E t E s E j i _ a r E 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 (print): - TESTS WERE COMPLETED ON: J~;3 ~~M1iS CE TIFICATION NUMBER: PHONE NUMBER(optionall: ADDRESS: • Wo IL ROAD CST SIGNATURE: HUDSON, WIS. SW16 DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - r Y, ?tJ v f sat 's4`~0 , in r1ir ~.a4,sratc t),1 .c.: ,'t~/C)i#1" ..s~.,~S" ral (tli'tS: of bf,d3`L3r r a o aTI[71 eat"C ~d usu, }3~an! . Pvv o r rdacerraow A S)3 FF IS 1 as r Cjrt (r=„'d P ~ 2 I_. .r s+ a.? t L -PIA S ARE RULE, 3 i,.+ l,.fi UU N I „ 3 ? O €1l S , SE ;e the abbs,avia± i a r I . Iokv (1 <a° tsar 41 riti3,9 P~,)h da (Iescr; E€~ , acid co ,pl z< ,E OAK L FG ( I_ oli(jr,am J€t ye)_ " test ter<. , ravv c~ to slh-f~t mav he if x u`[, oiw .;r, € mk?! I a t D p t Y:r') ,rii- X14 c x ,)raja 3t£`, i as C3=iY?8t~ ~rT fSl~t aJPi as 00:.u Oii;h' E.t}i'afP) E} LfUG Oot P,g)Ply, flo a f'l€.A- in the o '"3rs the fni-nt and OicC voui ct Y{"exit s.rdrexs an 7'~?c,7i), c~.€Y9fia~it7tr 3)c. ~"I7~}t;7" ` C~ r , r a - E. -4-p dy Loan a" - 1 : { Nil t i ` ` ;,iiiy ` I-ay 34?mk- a ,il'i IL-1 pi REPORT ON SOIL BORON&S o PERCOLATION TESTS 115- PLO's"' PLAM PROTECT I'. D. ,Q. ST-eor 5-oey- d/~c . DA TE- t-MME-Si` E TEST!t'+I+T Co. t3i^a3, O'NEIL ROAD _ B_OB UI]IliG~l y$'Z "UUSON, wtS.._ 514016 ST a~ 1 S~- M oP05 $ ovSE mor LIE' 2.5. FT oe~ M~XE ~~QOM .gLL T~'ST ~~~~35. 'PRO POSE 0 Well. M V S + L.16- 50 6,f AIVAr Ffc.*l Acc Tle'ST" /9 ,PE"115. st< 11o,P%Z . 13m RE'F£~PtiVC~' i dF GP~EC1 5"-&c IDOI ) r 'rz ~ c 5,7- f fl~jr g_r. )9r LC T 1,06v IV AJ ,P. 64J. 45 LEGEND 1'/£v/41"701V oA 11",r. ,fF C Pr % 0, 0 7LO ~3 133 13 115 VA RA) lr IU0rc- hll()k'6 X S y sT~.-+ Si T E` r~ tic O EL;~ N1,11>4 dA, 0 E t 2 6L tar roo,. r •o L /00 1 ~ od y ~I o ~ i A o1)osL-,47 ; v ~ }~OHESiTF j 1. y C N \ -3 OD` , w 1 t ICD CO. Ti J ~n d, tur-) N y 7f 66 CV y rN 7 "dam 1 c 0~ s c )PD ~ ~ \ mod. - ~ ° Yl J ~ ~J \ tt - N_ 0° 52' 50" W. PL IN i + A r y 36 1 Q, O' .7EC,T _ ~IA 00 fr. rpo I aS~ 1 r i i'R t MASTE ! ER & DESi',N; p LAC. Fresh Air Inlets And Observation Pipe Sort- TESTtsJy BY 6.OMES TS 1ESj'1;N ~eCd. lah,proved Vent Cap HUDSON, a1;tso16 Minimum 12`i Above Final Grade,- : rt0 Above Pipe Vent Pipe -f -o Final Grade Marsh Hay Or Synthetic Covering soy Min. 2" Aggregate 5 Over Pipe _ ~C Distribution Tee t j Pipe 0 0 0 0 0 Aggregate o T Perforated Pipe Below Beneath Wipe (~aupling Terminating 9, t_~ Pr III