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HomeMy WebLinkAbout020-1077-90-000 0 co 0 O -0 0 f o v1 3 ID 7 O A M 0 CD -0 3 co ;F -I Z O ? S N O O IthcC, O CD n C N N 3 o m rn o ch N° _a z I~ N Cn N O c0 r L. 0 co cu 57 0 CD N 1-0 Q n j F O j O \ C) O O C: c 0 0 cn o cn 3 c o O o O O co A- y c cn O s G D m°,. o m E fD n Q n 7 N W G C a C ~ O a a ONO A C CD co co (0 (D S (n O c \r 'p 'A a Q lVV O T h z 0 0 0 7 • c cn cn ai m M. ~C, v v v (D =r (n - 90 o fu 1 CD cr Q M CO) O w CD CL DWO O a - h 'CD h• I,D CD O N _ (p N 10 z(D c I vi O n s: ? ,jj v~ a Z O 0 W - CD CD co 00 O_ Z 'O U O cD N M G Z < m A G3 mw r 'o. w i c N N 1 O C.) O "V (D G T O 7 n S 3 y. a paj (D O O O m a = N T O O r, O O U) A O 3 N O ' N N O c ~n vi a s CD 0? 4 cfl O O O ~ a O a Parcel 020-1077-90-000 02/10/2005 09:24 AM PAGE 1 OF 1 Alt. Parcel 28.29.19.315C 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 * MEULEMANS, JOSEPH A & SUSAN M JOSEPH A & SUSAN M MEULEMANS 507 CTY RD UU HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 507 CTY RD UU SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 3.800 Plat: N/A-NOT AVAILABLE SEC 28 T29N R19W NW NW W 533FT OF N Block/Condo Bldg: 353.5' Tract(s): (Sec-Twn-Rng 401/4 1601/4) 28-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1118/583 WD 2004 SUMMARY Bill Fair Market Value: Assessed with: 48253 262,500 Valuations: Last Changed: 10/29/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.800 52,500 150,600 203,100 NO Totals for 2004: General Property 3.800 52,500 150,600 203,100 Woodland 0.000 0 0 Totals for 2003: General Property 3.800 52,500 150,600 203,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 128 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 2-~ w ST. CROIX COUNTY WISCONSIN ZONING OFFICE 9YMIIpIION■ NIYNG ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road ' Hudson, WI 54016-7710 (715) 386-4680 March 20, 1995 Landmark Bank l C~ `'fir (~n2~~~ Box 808 Hudson, WI 54016 Attn: Karen RE: Water Results for Charles J. Schoenoff Address: 507 C.T.H. "W", Hudson, Wisconsin Dear Karen: Enclosed is the original test results from Commercial Testing Laboratory, Inc. for water inspection of the above property. If you have any questions regarding these results, please do not hesitate in contacting our office. Sincerely, Matey Jenkins Assistant Zoning Administrator db Enclosure COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715-962-3121 800 - 962 - 5227 C:I: FAX - 715 - 962 - 4030 kEPUK1 DAJE; 3/16, 141 CARMICHAEL ROAD - UDSON!<. WT OCATIONs 507 C.T.H. H!. .OLLECTOR: M. Jenk i rte COLLECTED: 3-13-,.- COLLECTED. 2:15=s~~ CE OF SAMPLE. hitG!)?:r rt.. h Y.7043-14-'T5 s, :.ED t 2:Os,~~, ~r. .,1v s 1 RPRETATION; Bacteri i pp; ave 10 Conform Bacteria/10 OF.\NDEPENp t. 2~ e O ~n ti J PROFESSIONAL LABORATORY SERVICES SINCE 1952 qs, r ST. CROIX COUNTY WISCONSIN " a N ZONING OFFICE " """"e- ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road _ Hudson, WI 54016-7710 (715) 386-4680 March 13, 1995 Landmark Bank Box 808 Hudson, Wisconsin 54016 RE: Septic Inspection for Charles J. Schoenoff Address: 507 County Road W, Hudson, Wisconsin Dear Sirs: An inspection of the septic system for Charles J. Schoenoff located at 507 County Road W, Hudson, Wisconsin, was conducted today, March 13, 1995. 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. Also, water samples were taken. Once we receive the results we will forward the same on to you. Should you have any questions in the meantime, please do not hesitate in contacting this office. Sincerely, Mary J. Jenkins Assistant Zoning Administrator mz • , %./'ROIX COUNTY WISCONSIN v 1 u u -u u no r ZONING OFFICE ■~~.i ST. CROIX COUNTY GOVERNMEN CE.i7ER 1101 Carmichael Road ~Y - Hudson, WI 54016-7710 (715) 386-4680 SEPTIC INSPECTION / WATER TEST REQUEST FORM C, Please specify desired test(s) & remit appropriate fee with _ application. Outside water lines are often turned off during winter months, making access to the home necessary. Please make arrangements with this office to insure that entry can be gained. ❑ Water (VOC's) $185.00 [3 Septic $50.00 '5~,Water (Nitrate & Bacteria) 45.00 ❑ Nitrate & Bacteria retest $15.00 Owner: Requested by Address: ~~"1 Address /~i , ZIP Telephone N4: Telephone W: (~i' ) Property address (Fire N° & Street) Location: /,°k i Sec. , T N, R / 9 W, Town of i- Realty firm: Lock Box Combo: Closing Date: TO BE COMPLETED BY PROPERTY OWNER PROVIDE A SKETCH OF HOUSE & SEPTIC SYSTEM ON REVERSE OF THIS FORMS Water sample tap location: A, Is the dwelling currently occupied? Yes 0 No If vacant, date last occupied: Age of septic system: /Ir r, : Septic tank last pumped by. r/,' 7/%1- Date: t./ Previous Owner's Name(s): IV A Have any of the following been observed? ❑Y ,PS1N Slow drainage from house. ❑Y ,SIN Sewage Back-up into dwelling. ❑Y ON Sewage discharge to ground surface or road ditch. ❑Y IRN Foul odors. Other comments relative to system operation: a- I certify that the above information is complete and true to the best of my knowledge. i, OWNERS SIGNATURE: DATE: 1/94 OWNERS DRAWING OF HOUSE & SEPTIC SYSTEM LOCATION w IN f u TO BE COMPLETED BY INSPECTION AGENCY System design &/or permit on file? []Yes ❑No Soil series per SCS Soil Survey: sheet # Type of soil absorption system: RBelow grd ❑At-Grd []Mound Approx. size 'X Ctravity []Dose []Pressurized Ft.2 []Bed []Trench []Dry Well []Holding Tank ❑Outfall pipe OBSERVED DEFICIENCIES []Other []Unknown Septic tank Setbacks: []House L []Well []Prop. line " []Other Dose tank Setbacks: []House []Well []Prop. line []Other []Locking cover []Warning label []Pump/Floats []Alarm []Elec. wiring Soil Absorption System Setbacks: []House []Well v []Prop. line ✓ []Other ❑Ponding s r []Discharge: General comments: INSPECTORS SKETCH OF SYSTEM LOCATION N Inspect f~ Title Form - S T C - 104 • AS BUILT SANITARY SYSTEM REPORT OWNERCh(llC"` TOWNSHIP hVS0't SEC. Z~ T N-R_Zf_W ADDRESS !C X ST. CROIX COUNTY, WISCONSIN ~f UDSO~ ~j/S . SUBDIVISION LOT LOT SIZE PLAN VIEW i Distances and dimensions to meet requirements of H 63 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ,t Z t -.1 iA b/ I 1 9s Zt 0 1. 0 f.~ y ~zl ~ s 3 y 1XISTi,0 ~C yaE~o f~c~~ INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used 7~ /7,~%(JJt D Elevation of vertical reference point: X00 Proposed slope at site: SEPTIC TANK: Maaufacturer: Liquid Capacity: 3~:~-Tank Number of ri~tgs used: manhole cover elevation: /a 7- Tank Inlet E evation: w 3. Tank Outlet Elevation: /6.3 ' 36/ Number of fe ~t from nearest Road: Front,(,/'9 Side,0 Rear, O 2(~' feet From nearest property line Front, 0Side, 0Rear, 0 J /LTD feet y7, Number of feet from, well 3 building: _ (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REV!?l:SF S1 1)F PUMP CHAMBER Manufacturer: Liquid Capacit Pump Model Pump/Siphon Manufa, rer: Pump Size Elevation of in ottom of tank elevation: Pump off switch elevation Gallons per cycle: Alarm Manufacture Alarm Switch Type: Number of et from nearest property Tin\Front, ~Side, O Rear, 0 Ft. Number of feet from well: ` Number of feet from building: (Include distances on plot plan). SOIL ABSORBTION SYSTEM Bed: Trench: Width: Length:_ Number of Lines:~ Area Built: Fill. depth to top of pipe: M,4x/m t~~ yL Number of feet from nearest property line: Front, Side, O Rear, O Ft Number of feet from well: lZ Number of feet from building: SEEPAGE PIT Size: Number of pits: Diameter: Liquid depth: om of seepage pit elevation: Area Built: Has either a op box O or distribution box O been us on any of the above soil absorb n sytems? (Check one). HOLDING TANK Manufacturer: Capacity: Number of rings. Elev n of bottom of tank: Elevation of inlet: Number of feer in nearel; ;»-nnerty line: Front, ~0§-ie, '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: 3 3o -7 1&ilogs License Number: 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING MAVISON-, WI 53707 CONVENTIONAL ❑ALTERNATIVE State Plan lD Number (If assigned) ❑ Holding Tank E In-Ground Pressure E Mound ARIZAO~z NAME OF PERMIT HOLDER'. JADDRESS OF PERMIT HOLDER. INSPECTION DATE. Chuck Schoenoff 909 Fox, Hudson, WI 6 - ll yy 1111I 3a BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.: CST REF. IT ELEV NW NW, Sec.28, T29N-R19W, Town of Hudson Name of Plumber. MPIMPR SW No. County Sanitary Permit Number Robert Ulbricht 3307 St. Croix 49465 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV.. WARN NG LABEL LOCKING COVER / P OV DED PROVIDED NT'V-0 lr~,~( YES ONO EYES ENO BEDDING: JV A.. VENT MATL JHIGH WATER NUM ER OF ROAD: PROPERTY WEL~~ JBWENT TO FRESH ALARM. LINE. '_1 / AIR INLET FEET FROM ~LI EYES O S ENO NEAREST i DOSING CHAMBER: MANUFACTURER BEDDING. LIQUID CAPACITY PUMP EL PUMP,SIPHON MANUFACTURER WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: EYES ENO DYES ENO EYES ENO FRESH GALLONS PER CYCLE: P P A D NT LS OPERATIONAL. NUMBER OF P LRINOE PERTY WELL BUILDING I VENT AIR INLTOET (DIFFERENCE BETWEEN FEET FROM PUMP ON AND OFF) ❑Y ENO NEAREST SOIL ABSORPTION SYSTEM. Check the soil istureat the DIED h of plowing ( FN(,TH DInMETEH MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: WIDTH LENGTH NO. OF DISTR. PIPE SPACING COVE INSIDE )IA &PITS LIQUID BED/TRENCH 1 TRENCHES r ( MA rNBER PIT DEPTH DIMENSIONS L GRAVEL DEPTH FILL DEPTH UISTH. PIPE OISTR PIPE DISTR. PIPE MATERIALNODISTOF PROPERTY WELLBUILDINGVENT TO FRESH BELOW PIPES ABOVE COVER EL V. INL 1 E EvEND PIPESFROM LINE AIR'N L=T ~ ~I3, 7 z EST--~ I MOUND SYSTEM: 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- meets the criteria for medium sand. TIONS MEASURED. EYES NO SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS EYES ENO EYES ENO DEPTH OVER THENC H.'BED DEPTH OVER TRENCH; BED DEPTH OF TOPSOIL SODDED SEEDED MULCHED CENTER EDGES EYES ENO EYES DNO EYES ENO 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 NO DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING ELEV.. ELEV.. DIA. ELEV.'. PIPES DIA.: ELEVATION AND DISTRIBUI ION VERTICAL LIFT CORRESPONDS TO APPROVED INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL PLANS DYES ENO EYES ENO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY ELL. BUILDING. FEET FROM LINE 4 f t~ EYES ENOQ EYES ENO NEAREST Sketch System on e aln ounty file for audit. Reverse Side. sIGNATU TITLE DILHR SBD 6710 (R. 01/82) ====in= wisconsin APPLICATION FOR SANITARY PERMIT &-,~-,/_COUNTY 1 L H R (PEB 67) rRlra -',nOUS nOUS TTR1,LFIBLF1 OF 6HUTRnRELF1TIOn5 UN~IF/4 /RM SANITARY PERMIT # -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 sizlel/. -See reverse side for instructions for completing this application. PLEASE PRINT PROPERTY OWNER MAILING ADDRESS U Gk/ S,c 4 C>e1v O f ~d 141 op-J-0 ~.J 601T PROPERTY LOCATION CITY: VO1 /4'Vo1/4, S 9, T N, R E (or W Tow GF: ~Op rQAl LOT NUMBER BLOCK NUMBER SUBDIVISION NAME NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER 3• cv- W - 72 ifl TYPE OF BUILDING OR USE SERVED ` , aaa - LlJ77 Q~ 1 or 2 Family Number of Beciroilmsi ❑ 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. g 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 Al Lift Pump Tank/Siphon Chamber Holding Tank capacity N Manufacturer: (t~ jf' c'0~1/Gt2 f~C Oe <:-'0 IkIl P 4J~ ~Q C,4r7 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): PROPOSE=D (Square Feet): (n/S 36 /fr X 3 Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. are of Plumber (Print): Signatur IW/MPRSVV No.: Phone Number: 0 $t 7- 2t/_ 13,fi c J~47_ 3,707 (70- 3d~~ ~~dS Plumber's Address: Name of Designer: ` 3 0 AjEiL ~v• /vvSD.~ ~~s• J'Yo/~ -COUNTY/ DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Dat ❑ Disapproved ~C l r/ / ❑ 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 t u J 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.) ; 1 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 APvLICA'1'ION J ,01c SAi1 '''ARY PERMIT ' V 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/contracVQk,("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 Location of Property N ~4 N '4, Section I-S) T Z/ N - R ?__OW Township VO_r a Mailing Address fti D Sa.J Subdivision Name Lot Number Previous Owner of Property Total Size of Parcel 3.~ S va 2 2- ~ Date Parcel was Created /°I SQL LJ Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes No Volume , and Page Number Z 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 1 (we) eext,t6y that aU 6tatement6 on -thiJ 6onm aJLe tAue to the best o6 my (oun) knowkedge; that 1 (we) am (ane.) the owneA(h) o6 the p&opeAty deacAibed in thin in6o,unation,jonm, by viAtue ob a watAanty deed neconded in the O~~ice o6 the County Regis teA o6 Deeds a,6 Do Cument No. 31)0 ~ ; and that I (we) Z 7SV S pAuent.Ey own the pupozed .6it2 bm the 6ewage di6pozat /system (oA I (we) have obtained an ea6emen~t, to tun with the above descA bed pnopeA.ty, 4on the constAuction o6 aaid eya.tem, a;ad the same h" been duty necoided in the 06jice o4 the County Reg-usteA of Deeds, as Document No. ) . SIGNATURE OWNER SIGNATURE F CO-OWNER (IF APPLICAB ) DATE SIGNED DATE SIGNED ~t~C~V11i~ V ~i u, /f~ /If oV 61 ~ 'I C - to,) r Y IPT t C CANT-, f!'I'FINAN( to o t. Cro i_x Ccittttt y z~ G~49 G U L,I l I: / l i I I Y I i ( i'~/fjG~ _ <~d~`'t'Ly"w~c"` `~/y3d _ _ i• t kt)11TF/BOX NUMB EP, Fire Nuntltt i 1 11 12- 11 I'Rtl1"NITY itit':1I'I:tN:~/lt~ 1' ly N, Iv W, I wn ctt SL. Crui_x Co(1nty, I it lid iv is it,it Lot- littlilhel' I intl~tt~pcI :utd urailit er.anc c ul your. :;t 1tt it r;y:,luat cttul~l rc! ctlL in cnnutc cun- it:, I,ruwaLucc~ I;tilttrc Lu h;andIc wusL~~:~. I'rul,t~r utailit i Lt; oI httlit 1) i11 uuL tlhu Scp Lic Lauk c vc•ry LIIrec yc I Iut' :;uttnur, 11 rteuded, b a t is L.rtsed se ,t is Lack taut )c'r. What. You Fitt i lit u tlae sy:;lt~ttt .'au iI I eL' It LIIU I kLIt CL iun ul t I,. meat stclkt! i.u the wash'- di:;ltusal system S t . CruLx Cutlit ty resl.detltw:ty he e. l.i}r,il:i~ , a Ittaxi❑tttQt ctC 60Z ui Ctic cu;;t ul reltiaCetlteit L oI I fat l i.tt}; ysLcill Wit iClk was in u1,~-raL1oI1 1trioI Lu I(1ly t., Ill/8. (;rude C LlIIt- y accUpu•d Lh'is Itrutrant Lit A(1i;ust 01 198G, wLth tit k. rt:(luiruIlk eit L ChaL 0WItk,1 ul tl l 11 rw .iyLi trtu~, .~,1 Lu Icei~1) the=ir systi,Ill s 1)1- 0 1turIy oat i n L ;a i rt .±cl . I' I 1>t'ulac rt v uWItl r ti;rrt tthIll l t Lo iL CC1)ix CitLt uLy 'l.0 It i 11 rtiI I itt iit it I<trill , :iiti,II Lht, ow11Ur alld by a tuct:;LcC Itit_tIli hUr, [I meYtit;tta La l uIlk hCC, resat r i.C t 0d i It Ilk hl_1, or n 11_C Ott r.; c•d l~th1,t.'r vc'r i- lyitt} [heat (tj t.ltci Oit L I, wit steWit ker di:itt(',;al. systc~ill 1trul>er I,t•rit L tit c 11kl i t iuu null 1 ;II t t r 1.11 s1) cat iuu 11d lait lit 1) 11 it cc :s'J.FY thu ~c1>1 1c La11 i:. lc' that[ 1/3 1(1 11 01 lucltad sc(Ill) rLii ic;rt [c.t[I iurt'wiI I ht it I. it 1)1)r-uxiuuait Iy 30 dny;s ltrittr Lu t Ill l'e yuar Ux1a i rctL iun. -t O I /Wl:, tltc uttLt ers_i(1 11ilVC read LI I c it hit vt rc'cluir011Wrtts and itl',I L'e U, tt~ ntainLit i11 Lha, lari.vatc~ sc~w.adisl>usal .;vsLeill in ;1ccurdit it ce with x F-, tIt(' standards scat IuFLIt, Ilk Cc iu, I ~;et by LI Wiacut[sitt N' ltctI'I. ~ ntCuL of NaLLlrit I. he5uurct Cart -it icat iun i unit must he completed ;tad r0LurIt ed t0 Like SL. Crt,ix County X,,uniit GLIiwi.tIt i*u 30 days of Lhe 1,1 L_ 0 yL'1ar exltirit t.iuit datt'. I OAT I': i tr~ti:- Cttutit.y 7.ttnitt~ P.G. iiox 1lauuut ud, WI 5It015 715- Alta- > 1 or 715-425-8363 ` I ;II date, artd rc•t- u[- n I ll ;ihuvc• it(Idrt:;~s cr ~0 DEPA iTMENT OF REPORT ~C ~ ' SAFETY & BUILDINGS ' INDUSTRY, ON SOIL BORINGS 'h U DIVISION LABOR-AND PERCOLATION TESTS (15 eaz;` ' 98' P.O. BOX 7969 kf~1N►AfV'ELA710NS MADISON, WI 53707 ' LOCATIH/4 CTION: .TOWNSHIP/MUNICIPALITY: L BL K. NO ISION NAME: c+~ /T 4 N/Rid' E W //Ci2fe) c~ COUNTYNER'S BUYER'S NAME: MAILING ADDRESS: c,P©yoe k S~~ &)'0.'V USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: I ONS: 1PERCOLATION TESTS: Residence New ❑Replace RATING: S= Site suitable for system U= Site unsuitable for system l 7 d 7 d CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEonal) V'S ❑U 0S OU ®S ❑U DS ❑U ❑S DU M:(opti If Percolation Tests are NOT required DESIGN RATE: SYSTEM ELEV. If any portion of the lot is in the under s.H63.09(5)(b), indicate: [Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS dCiL S;O~~iEs = BORING TOTAL ELEVATION D PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- • a.,. B ? L/ Z- 71 - 11 Si > 4A;- 574, Gf B 5• Sr i/ / ~P ~~Q~ G/AJ. SL , G ~i (l. s'G ••'!'~P -QN CAS B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PERIOD PER INCH P_ rt/ary..~ l P- 2- P cm~C G P- p_ _ P- PLAN VIEW: 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 perc,nt of land slop. 6 D 1307 76H R , 00 5119. F/• /:;"f L,- % 4e SYSTEM ELEVATION F©,e? VCIT - OM o ~',ea /,Pa v Pi e 3o" 3 o '4 ( ST' F 1>I~UEli/xy 13 /''/00 -fill oil 0 t4z' IAI ~J~,(1G~/1t SEl~ e`',Yl30 lUEf/ - i, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures methods specified in the Wisconsin Admimistrative 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: T Zl%biPic/ 4"iz L 6) / ADDRESS: , CERTIFICATION NUMBER: PHONE NUMBER optional): Te r- .3 0 . z/L f~UDSc~-✓ S • ~yc~/ 5 S _o 2- y,~ . ~ .~~~1~/".~ /J~C~S L"~YC~/j!/~T~~~, CS,T SIGNATUR oral A~ithority, 2nd page-Bureau of Plumbing, 3rd name Penn= ilTester. . PLB ~7 Y , S r LOT anciCRO55 S6CTION PIANS ' 3 ftL'IiPAMtE r r~ i \ wi~ U sa PAY 01f AZW So o~,~, o f f:~-- ,~o,, ~ R (q W X f l U k) Se'.1 Fresh Air Inlets And Observation Pipe SOIL TE!mr -N5 ey "OiHIESI 'E 'DES JNG f.G. rm3, C't'dkiL Approved Vent Cap HUDSON, Wis. '4016 Minimum 12" Above Final Grade J~ iv3.&F' 4 Cast iron -~T 1fL ' Above Pipe J~ 'o Final Grade Vent Pipe I Jl fT 7 Morsh Hay Or Synthetic Covering pr Min. 2" Aggregate Over Pipe op . Distribution Tee f' Pipe GO-0 0 0 0 ~3 " Aggregate o Beneath Pipe Perforated Pipe Below 0 Coupling Terminating At -~"7 Bottom Of System