Loading...
HomeMy WebLinkAbout236-1759-01-000 M 1 O y f c d 0 c 3 0 3 v~ m x~ 3 l n O0 w a: 0 vi o A C 'III n W `C • m 51- 3 B 9 CO CD 91 00 z n :7. 0 CO (D *ft ( O Q, co 5 ~ CL - = o N 7 NO N N d d CD -0 0 O :3 (D o C cn N O :3 K A (DD w C D (D F' A (D (D N C Z7 N yr~' co c n o l o N G~ l }i CZ-. 3 p o \o ~7 dQ~, c°\n rn cn c~ (DD b to CSI] CL ( - co CD CD n r to (D rl CD 00 co Fl- 0 4~ 41 rrt (D C m • O o O O O c a T ~ o D U v 0 6: 6.3 H (D` rt o m O A N Z E v~ g L u. o o CD - rn cn A r_ n: r~ C CD m rn t^ - O r. rh C CL N ° z ca z o T CD V) C.f`t 00 r1(D x -a U) ;t N l A_ _ 00 , " ^ t c m CD p r-3 H Z W m n o tv m 3 o CD ~ y Z Cn o A Z 1D O ~o n N A Z O NO U] Oi n C.) 7 i z ~ W ci G n I~ CD+ rt W M N) 01 o° N r• a 3 ~ z n o 0 r O m o o w y z rr rt a, CD a a n o - T N C ' z o 0 CD N I ~ I I O o• m I ti I o 0 a A A I, N O 0 N 1 O t Parcel 236-1759-01-000 10/04/2006 09:15 AM PAGE 1 OF 1 Alt. Parcel 236 - CITY OF HUDSON Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - NUEBEL RT, EDWARD F/SALLY L EDWARD F/SALLY L NUEBEL RT 1844 RIVER RIDGE RD HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description " 1844 RIVER RIDGE RD SC 2611 HUDSON Legal Description: Acres: 0.000 Plat: N/A-NOT AVAILABLE LOT F CSM 2/567 & AS DESC DOC #401684 Block/Condo Bldg: 711/314 Tract(s): (Sec-Twn-Rng 401/4 1601/4) Notes: Parcel History: Date Doc # Vol/Page Type 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/02/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.200 155,000 333,400 488,400 NO 00 II Totals for 2006• General Property 2.200 155,000 333,400 488,400 Woodland 0.000 0 0 Totals for 2005: General Property 2.200 155,000 338,900 493,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER --rP ~V U~6FL TOWNSHIP SEC. T N-R Z~ ADDRESS 13 & Y3 ' ST. CROIX COUNTY, WISCONSIN ~WNSall/X SUBDIVISION 194vZ' LOT LOT SIZE esM vo/ PLAN VIEW Distances and dimensions to meet requirements of H 63 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM Off , e s . y0 PgL .S ~ gy ~y VEi 1-. y~► Ut C '0fF' ,a Pip C-) Q ~}P,eDN (INDICATE NORTH ARROW wr~~-t►/soRs G~~F ~,~ow - tiok~ Tp BENCHMARK: Describe the ver,Jcal reference point used fI~O~Pd u /0 0. 76 ' Elevation of vertical reference point: pik2 -166 " Proposed slope at site: SEPTIC TANK: Manufacturer: Liquid Capacity: Number of rings used: &6j~67-- Tank manhole cover elevation: Tank Iplet Elevation: P ~ lank Outlet Elevation: 97, w Number of feet from nearest Road: FronL,o c-,_a,:,0 Rear, V feet 0V I From nearest property line Front, ~Side, ®Rear, 0 feet Ne;W014 S . Number of feet from: well -7~ building: Td I (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SIT; S H)F ti PUMP CHAMBER Manufat urer: Liquid Capac' Pump Model: _~~~'Siphon ufacturer: Pump Size Elevation of inlet: Bottom tank elevation: Pump off switch e ation: Gallons per c e: Alarm Man cturer: Alarm Switch Type: N er of feet from nearest property line: Front, O Side, O Rear , Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: "-Q3 Width: I Length: YF Number of Lines: -3 Area Built: Fill depth to top of pipe: IA4,+X/Af o,,-, Y.Z , Number of feet from nearest property line: Front, © Side, O Rear, O Ft Number of feet from well: /HON` Number of feet from building: (Include distances on plot plan). SEEPAGE PIT Size: N Diameter: Li epth: Bottom of seepage pit elevate 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: Capaci Number of rings u Elevation of bottom of tank: Elevat on 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 rom nearest road: Alarm rianufacturer: Inspector: i Dated: Plumber on job: HnM211E RE 3 O'NEIL RD.; HUDSON: WIS. 54016 License Number: ROBERT ULBRICHT NO. 3307 M.P.R.S. MINN. INSTALLER & DESIGNER LIC. NO. 00663 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.U. BOX 7969 BUREAU OF PLUMBING MADISON, WI 53;'07 CONVENTIONAL ❑ALTERNATIVE E77 ❑ Holding Tank ❑ In-Ground Pressure E] Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER'. INSPECTION DATE. Ed Nuebel 13645 Oakwood Ct., Burnsville, MN 0 BENCH MARK (Permanent reference Point) DESCRIBE IF DIFFERENT FROM PLAN REF. PT. ELEV.: CST REF. PT. ELEV. NE SE, Section 36, T29N-R20W, Town of Hudson, Lot F Name of Plumber_ MP/MPRSW No.. County Sanitary Permit Number. Robert Ulbricht 3307 St. Croix 54959 SEPTIC TANK/HOLDING TANK: MANUFACTURER'. LIQUID CAPACITY. TANK INLET E)rE~V.7 TANK OUTLET ELEV.. JWARNING LABEL LOEXD C E C/~ / y PR V DED. PR~ <l-I ~L~Z ((ry YES ❑NO SS NO BEDD ING: VENT DIA.: VENT MA L HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING. VENT TO FRESH ALARM FEET FROM - LINE'. AIR INLEL ❑YES NO G ❑YE NO NEAREST / 1 DOSING CHAMBER: MANUFACTURER BEDDING. LIQUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER PROVIDED'. PROVIDED ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. NUMBER O~F PROPERTY WELL BUILDING VENT To FRESH (DIFFERENCE BETWEEN FEET FRONE AIR INLET PUMP ON AND OFF) ❑YES ❑NO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing ENGTH DIAMETER 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: BED/TRENCH WDEPTDISTH NOOF DISTRPIPE SPACING COVI' ISIDF DIA -PITS LIQUID TRENCHES MAT,FAL~PIT DEPTHDIMENSIONS ll GRAVEL DEPTH DISTRPIPE DISTR. PIPE MATERIAL NODIST NUMBER OF RTY WE ILDINGVENT TO FRESH BELOW PIPES LEV. END PIPE' AIR INLET Z q2 FEET FROM A NEAREST--p-1 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 ,.QN EVERSE SIDE. SHOW ELEVA- meets the criteria for medium sand. TI S MEASURED. ❑YES ❑NO SOIL COVER TEXTURE JPIRMA" J T MA7ERS OBSERVATION WELLS / NO ❑YES ❑NO DEPTH OVER TRENCH.' BED DEPTH OVER TRENCH: BED DEPTH OF TOPSOIL SODDED I SMULCHED CENTER EDGES ❑YES NO ' ❑YES ❑NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH LENGTH NO OF LATERAL SPACING GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER TRENCHES'. DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL'. N D/STH. DI TR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING ELEV.. ELEV.. DIA.. ELEV.. PI ES. D A.-. ELEVATION AND [DISTRIBUIION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER L VERTICAL LIFT CORRESPONDS TO APPROVED PLANS. ❑YES ❑NO ❑YES ❑NO COMMENTS:' PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPE RTV WELL. BUILDING. FEET FROM LINE ..A ❑ YES 1:1 NO ❑ YES 1:1 NO NEAREST G G . L 1 a- l e v C' . Sketch System on Reta n unty`file for audit. Reverse Side. NATURE TITLE. DILHR SBD 6710 (R. 01/82) % E~L:APPLICATION FOR SANITARY PERMIT COUNTY D 1 L H R (PLB 67) UNIFORM SANITARY PERMIT # _ USTRY. LRSOR 6 HUMAn RELRTIOns y~ -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 PROPERTY OWNER MAI ING ADDRESS 51) ,1,4e PROPERTY LOCATION CITY: oy,)J f C1 Aj N 1/45E1/4,S369 ,T2-4,N,RLoE(or)W T ~r LOT N MBER BLOCK NUMBER SUBDIVISION NAME NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER CS.~ 1 V Z 44 / X ~k i V Q,~~ ti TYPE OF BUILDING OR USE SERVED X 1 or 2 Family Number of Bedrooms. ❑ Public (Specify): THIS PERMIT IS FOR A: New System ❑ Tank Replacement ❑ Repair Replacement Soil Absorption System ❑ Revision ❑ Privy Alternate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. Seepage Bed ❑ Seepage Trench ❑ Seepage Pit ❑ Holding Tank System-In-Fill ❑ In-Ground Pressure ❑ Vault Privy ❑ Pit Privy ❑ Existing, For Which A Previous Permit Is On File, Permit # issued An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions. Total # of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity 12- du Lift Pump Tank/Siphon Chamber Holding Tank capacity manufacturer: W gEZe5 Ga -V U -y- ocrs- N) EI,) C 6,--,0 LD w I IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: ❑ Mound ❑ In-Ground Pressure Total #of Prefab. Steel Fiberglass Plastic Ta e Constructed Septic Tank Capacity Lift Pump/Siphon Cha M a n u f a er: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Minutes per inch): EQUIRED (Square Feet): PROPOSED (Square Feet): V3 Lo E/,? r7u r [ Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumber (Pri ESITE SEPTIC PLUMBING CQ. Signature: IW/MPRSVV No.: Phone Number: V.~t AT. 30'NEiL RD., HUDSON, wIS 54 16 33 0? (715) 3doc-~/F Plumber's Address: Name of Designer: "S. MASTER PLUMBER LIC. N0. 3307 M.P R.S. COUNTY/ DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: ❑ Disapproved 1 `f ) j Fes' Y' i ❑ Owner Given Initial ~j X 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. APPLICATION FOR SANITARY PERMIT 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 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. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - (timer of Property ~ ~E13~~' j A NO Location of Property N L~4 S~-Jy, Section T N - R 20 W C('4f o t4 u 0f'o o Mailing Address G 1 i `f l A" 4-) 0 C~ ~ . b . Subdivision Name S U-o L 2- 5'6p 7 Lot Number F Previous Owner of Property A-) Total Size of Parcel L Date Parcel was Created Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes No Volume Z and Page Number S as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: I. 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. PROPbRTy OWNER CERTIF=ICATION I (Wc,) ceh t,i~ y that a.E( s tatement6 on -thin 6on.m alLe tAue to the best o6 my (ouA) tznowtedge; that I (we) am (ane) the owneA(,S) o6 the pnopeAty danibed in -thi.6 t,n6onmation {ohm, by viAtue of a waA anty deed neeonded in the 066ice ob the County Regi.6t n o6 Deedz as Document No. 3 VF5,~- ; and that I (we) p4"entty own the phopoAed site 6m the 6ewage dizpo6at 6y6tem (on I (we) have obtained an easement, to nun with the above de~sehi.bed pkopeAty, Ooh the condtAucti,on o6 said /sys-tem, and the Same has been duty seconded in the 066ice o6 the County Reg-izteh o4 Deeds, ah Document No. ) . SIGNATURE )I? OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED ink -3 i rY.f s ~ o % O 0 \ ~~a y LOT F C TIFIED SURVEY MAP \ 4 - VOLUME 2, PAGE 567 l ~ ''~rOO O ~ t S Xh fl~ f~1~ sw CORNER \ SECTION 38 COUNTY MON Pp~ A a,~cel nf lane locates.' 11A :0vr. City of Hudson, St. Croix. County Comme'ncinq at- the NW corner of L the St. Croix County Register of of this description; thence S 29 West 255.00 feet to a point whit and is the beginning of the mean line, 100.00 feet to 'VIA point whi saia m«-ancl-,r- _ .ne;thence N 700-3 lying between the meander line h between true extension of t,he`sc i SQL- 36 - H H y r ST C- 105 r y SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County d OWNER/emu NC9E SA 3 L- rr, ROUTE/BOX NUMBER o k G Ca Fire Number CITY/STATE.' 1 A/, ZIP PROPERTY LOCATION: ~4 ~4, Section 3( T~N, R W, G~ (O lot-) St. Croix County, f Pv-'r-n, of L) D Subdivision_VoL' 2_ nJ ' s~O / Lot number Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. - Ho I/WE, the undersigned, have read the above requirements and agree Un to maintain the private sewage disposal system in accordance with H 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. S I G N E D 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. ~~DILFqR SANITARY PERMIT Cam. County . ~ ~„ffi~Kw.,. ~~►.~R.,~,..~,...a,. GROUNDWATER SURCHARGE Sanitary Permit No. ,S~ 9s 9 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 2 years of steady negotiation and public debate. The groundwater bill included the creation of over 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 holdin tank pumper. 9 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. :ur of Issuing Agent: Grounde s S#er Gro water F r. Date: WiscoFi$in's DFiD-7289 (N. 05/841 buried e 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) 104 vG : LOCaTION: SECTION: TatNRtsF~IP/MUNICIPALITY: LOT NO.:BLK. NO.: SUBDIVISION NAME: NE 1/ 1/ 3 Co /T 1 f Il 10 E (or W YL)PTo ~ F `pQ. 2 .56 COUNTY: OWNER'S/BUYER'S NAME: MAILING ADDRESS: 5- z4 i x *1 • yh l s . /1 /uEI3EL_ f~/~l~/~ U~//F ~'r /v.✓ USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: Residence 4- New ❑Re lace ? RATING: S= Site suitable for system U= Site unsuitable for system 6-es- 441-fa T '5,qN'9 s CONVENTIONAL: MOUND: ~N-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) ouVo~G --~1o ©s❑u r~s❑u ®s❑u ❑sau ❑sou e •Ara FI tLL7 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 /ti J>¢CJM&_e FT, 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.) B- 0 ' ~l l y f - - D • 67 A3,0. s, . s, f.2 ' 7,fAj PE.py r57 . 7f 33 ' 13X . , S/ 7 ' ;7l.,'Af",V B Z ~-s L /3 ,4,u v?' cs B S ' iap. 06 > 73- 131k• /s, ins / 3A1 10'M-,ft s , s•Oj ' 7-4A) u cs• B f. z' 7~ /a / > z k (S s, 67' 6N-Gy. s, 7S , . 3 A; . v~k cs Q . TAN v cs . B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME '1 DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIO 1 PERIOD2 PERIOD3 PER INCH P_ so/•L- 6001 S /FO M,444-A- GS So/LS P- w /djn d - 03' SU/~ dfi><S ~X/ S 71/,V /FPX -f 14 GI e P- fit / E' TEST ~L M S C-S _4K P- ~.v /N 6- # 'C-~M%A iG ft f'o P- r A / 2--0 +J IP. o 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 136 73- oo fir. i~ This test site APPROVE for a conventional septic system. '8'f`~~°~ 13 I '00 su rt,8/F' s la~,~ s AT3 F y . 30 • a s 40 rE S 7- ;%YS7 7- iv is 3 I yo 5-yt r ovr yo,,ks,~~ ?r 13 1 A3 DC) x 30 17 7 ' pi per: o,~ 5c~~dk I07" 1iaF. FEU. = /00.0 Fr. ~►z. Qn~ ctm Top of Ar•e coopinoorie couoorr pit-C. cei,GQ4 A- PAD /Dy 3 FT 6N ~LUff LtiJE SIT 6'-5- 7-- _WEll ' Dr4vE (3E-rT / St-tin QdF . I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (p TESTS WERE COMPLETED N- 14tt Q, ADDRES PROVED SITE EVALUATIONS (PERCTESTS) CERTIFICATION NUMBER: PHONE NUMBER (optional): WISCONSIN LICENSE 140.55-02482 CST SIGNATURE: '.3, Q111EiL F IiUDBox$ WI 54016. u,< , sst DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - gg g g 1 H `ix? .Cdr 7t .,°;AS s 0i g..e~.a4'J L„.E 2,iN'G FOR, a ~ i v 1~~ t€ q~!€~t~, <,+i€f ~~rvc 3 tie~i~%c~a }E,t,a ~r~t„rz 'Y)£i3t .rlA.'~at S's,i tI'sG` sE'+.$,::€^ '9t'+r +.E~t+aI~ °'u'$f tiJi, I, ~ss tE~ic.:vv€;2 (Jl ,u;=l_YI£;YCicll C7r,a1ecL; I'.:, ;rs. ILE R A H ~LD!NIG 'T VNII<< ONLY dF AL ~fS prill,S ARj" rji ii. 9"< .^j -t is 4„: I'.'-,, ix 1 ,a S...r , is'Ei S: . use c , b~ ~ 4,.~ r)t _s pi I€le. Cksic €PTiCIIs aOl Goer D:(` 'jrlg tip ?,slat plan, A € ESs1BI.,~_ t}=`agri v i1e!'y «ocahng )tf:or l .'l' ICcEL~{~~ls. ~c,l:r'vvsng to scale. ;s proftesii :1 ~s` ,<r, ;a'ki i 3 `u.i ,;.-31 i L 11,iC4,31. t"": ;:'C' in; nPC: cic',irly sisovv(1;'<7nd we ~~t~, ~.'i:. 4 1 >'I f}b r: tc~~.€3 3 .S ,r, €ict , ad"%i 'H io $ t£'S,i eXECl'3(7- 4.. if.o, ,T33_ v..,.;`=ft.its u„e$ps~~CY Yic#~J')csx; ,:Tt t:oi g,,, k36.iY'lr> ~ , P,fti rtaitaLC,! i"°r x s p 4, R C, ,.€°t. i. _ €i- L rl, .tv.: y v:, t.t 'ai L-, , „ P F t rS, F c a * -a ~?t = f,~ (?,mod€' LCt pit 3L` ~17i , .v. )p+4 ni ,i£,"', OPT /OC,19- 7-h CO."U'o a; PL"'*' ~ t 7 PLOT anj C005!5 TION ?A.V,5 A Ilk HOME-SITE SEPTIC PLL;bj6jPdG CO. RT. 3 O'PIEIL RO., NUOSO YTS. 540I6 i ROBERT ULBRICPf i a WIS MASTER PLUMBER LIC. K. 330! `14.P.R.S. 0NN. INSTALLER $ OEStt;PIE CIC. PIO : 83 /f 6 4 I 9 ~ ~ r~ E I i,- d f y'' ( 'sIto 4 ✓'t" i 33o L t e I ~ - 500 V- 1-0 A-~c re, H °o a A WIS. 1,4016 Mhnimum 12" Above Final Grade r1 a Above Pips ' Cast Ir fl? Vent Pipe g i=ire®i Grade - Marsh Flay Or Synthetic Covering Wn 2" Aggregate A Over Pipe , Disiribution flee 4~r fed ~ r3~ Pei 1 Coupling Terminating At [3 o t t orn C? t s t e ~-n _w