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HomeMy WebLinkAbout022-1095-40-001 o y o 3 -0 o m d `n 3 3 3 - O (n Cl) T, ~ N O O W ON • N CO S N N H ` N 7 3 N -4 (D (D N v CD n Cp p [A, a Z c F' (o Q A A N 7 O j . 1 N N fl- 7 7 -'I n p O p p O (D p CA N O O 3 N -4 O + CD CD M ' o N n a CD (D o N W N A C CL O 0 7 NO O O N C7 to "WNA C) 0 A A W Z Co Co n r N C ~o 7 o 00 0 0 (n c 7d M 1 ` O 1'I -D * * * T G Z ll~ll N I (o N N - D CJ'C (D G v vv2-E o ~ 41,p O K N C m y (r C 7 pa o cn 0) 0 (10 < -I 3 : • N W p 1~ ,tom,, 7 co C r! _ f O d \ ~ o ZD CD a O a ? CD Cn O W • . CD N ~1 O CL] N C CD C tl -P W CD -P N rn Z 7 O 'p Z CD C4 z M C~ rn CL 3 (n Q .r O_ d f`•S a' C~ Z N W W M m 03 C Z cca s c ° 0 3 Z o0 3 m Q ~ I v a E3 ° T 3 m c 7 O G 0 CD n m a a a CD A a ~ ~ CJ ~ n 3 ~ a m N 0 0 A o b W N O < ft 3a og O O C(D a p 0- r Parcel 022-1095-40-001 12/14/2005 08:31 AM PAGE 1 OF 1 Alt. Parcel 33.28.18.513E 022 - TOWN OF KINNICKINNIC Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - SCHREIBER, THOMAS & COLLEEN THOMAS & COLLEEN SCHREIBER 75 EMERSON VALLEY DR RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 3.860 Plat: N/A-NOT AVAILABLE SEC 33 T28N R18W 3.63 A NE NE LOT 1 CSM Block/Condo Bldg: 5/1387 ASSM'T INC 022-1099-20 001 P534-D Tract(s): (Sec-Twn-Rng 401/4 1601/4) 33-28N-18W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 689/277 2005 SUMMARY Bill Fair Market Value: Assessed with: 88846 314,600 Valuations: Last Changed: 08/11/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.860 65,000 253,100 318,100 NO Totals for 2005: General Property 3.860 65,000 253,100 318,100 Woodland 0.000 0 0 Totals for 2004: General Property 3.860 32,000 197,500 229,5000 Woodland 0.000 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 216 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges 00 Total 0.00 0.00 • Form- S T C - 104 r AS BUILT SANITARY SYSTEM REPORT OWNER S( ""a z c%fi 21P' TOWNSHIP C SEC.: T 1 'N-[i ADDRESS 1,&,,6 iST. CROIX COUNTY, WISCONSIN SUBDIVISION A LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H 63 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM G' I c I a 1.6 V X arc x INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used Elevation of vertical reference point: /j Proposed slope at site: SEPTIC TANK: Manufacturer: L ~f Liquid Capacity: i Number of rings used: Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: Number of feet from nearest Road: Front,(i~Side10 Rear, O yQ~ feet From nearest property line Front,0 Side,aRear, O > feet Number of feet from: well building: ZZ V (Include this information of the above plot plan)( 2 reference dimensions to septic tank) PUMP CHAMBER Manufacturer: D Liquid Capacity: R 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,0Side, O Rear, Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench Width: L ~ Length: Number of Lines: Area Built:_ 27 r Fill depth to top of pipe: Number of feet from nearest property line: Front, (,amide, O Rear, O Ft Number of feet from well: Number of feet from building: > -Sye' (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, O Side, O Rear, O Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: ~d- Inspector: Dated: Plumber on job: _ License Number: 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR LABOR & HUMAN RELATIONS SAFETY & BUILDINGS P.O. BOX 7969 PRIVATE SEWAGE SYSTEMS DIVISION MADISON, WI 53707 BUREAU OF PLUMBING • nA~GONVENTIONAL ❑ALTE R NATI VE State Plan I D. Number. ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound (if ae signed) PERMIT OLDER. ADDRESS OF PERMIT HOLDER'. T7 4)? ?j(b~ NSPECTI DATE NAME 1449 ASheand Avenue, S Pain, MN BENeerence point) DESCRIBE IF DIFFERENT FRO Nt T28N-R18GJ' Lod 1' EmmeAzon zub.Town o6 Kinn c. REF. PT. ELEV.: PT ELEV Section 33 Name of Pl umber MP/MPRSW No County. Sanitary Permit Number_ have Eogetty 3289 S C~catix 54947 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV TANK OUTLET ELE V.. WARNING LABEL LOCKING COVER n "7 PROVIDED'. PROVI~E BEDDING: VHIG HWATER C ❑~'ESp NO I ALARM NUMBER OF RO PERTV LDENT ❑YES FEET FROM LI" AIR INLET ❑YE N NEAREST (Lr f (llJ f 1-., DOSING CHAMBER: MANUFACTURER BEDDING. LIQUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER ❑YES ❑Np PROVIDED PROVIDED' GALLONS PER CYCLE: PUMP AND coNTROLS oPERAT oNAL -YES ❑ NO ❑ YES ❑ NO (DIFFERENCE BETWEEN NUM R O PH ERTV WELL BUILDING I VENT ro FRESF FEE FRO AIR INLET PUMP ON AND OFF) ❑YES DNO NE REST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing [N(,1H AA ETER 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 BED/TRENCH LENGTH NO OF DISTR PIPE SPACING C OVER N JE DIA #PITS LIQUID DIMENSIONS TRENCHES / M `IAL PIT DEPTH GRAVEL DEPTH FILL DEPTH DISTR. PIPF DISTR. PIPE DISTR. PI BELOW PIPES ABOVE COVER ELEV. INLET ELEVE ND LINE T vt- MATERIAL. NO. TR NUMBER OF PROPER aI/ / WELL BUILDING: VENT To FRESH !!QQ// PI FEET FROM AIR INLET'. a` 9/ NEAREST l~ ~y0 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- ❑YES NO meets the criteria for medium sand. TIONS MEASURED. ❑ SOIL COVER TEXTURE PERMANENT ARKE S. 085ER NATION WELLS BYES ❑NO ❑YES DEPTH OVER TRENCH BED DEPTH OVER TRENCH .'BEU DEPTH OF TOPSOIL ❑ NO CENTER EDGES. SCUD D SEEDED MULCHED YE ❑N ❑YES ❑NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH LENGTH TRENCHES ATERAL SP CIN GRAVE EPT BELOW PIPF FILL DEPTH ABOVE COVER : DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR_PIPE MANIFOLD TRIAL. ISTR DISTR. PIPE DIS fRIBUTION PIPE MATE HIAI&MARKING ELEVATION AND ELEV ELEV DIA ELEV. P PI P S Din [DISTRIBUI ION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATE IAL V EHTICAL LIFT CORRESPONDS TO APPROVED PLANS COMMENTS: PERMANENT MARKERS❑YES ❑NO ❑YES ❑NO OBSERVATION WELLS'. NUMBER OF PR OPER~Ll_ . B UILDING. FEET FROM LINE. ❑YES ❑NO ❑YES ❑NO NEAREST Sketch System on Ret n in county file for audit. Reverse Side. Y SIGNA TORE. TITLE L._ DILHR SBD 6710 (R. 01/82) - _ DEPARTMENT bF APPLICATION INDUSTRY, FOR SANITARY SAFETY&BUILDINGS LABOR AND PERMIT DIVISION HUMAN RELATIONS (PLB 67) P.O. BOX 7969 MADISON, WI 53707 707 Attach plans for the system on paper not less than 8'% x 11 inches in size. Include a plot plan that is dimensioned or drawn to scale. Horizontal and vertical elevation reference points must be shown. All appropriate separating distances and physical characteristics as specified in chapter H-63, Wis. Adm. Code, must be shown. An index page or each page must be signed, sealed and dated by the designer. If designed by a Master Plumber, the date, signature and license number must be shown. A legible reproduction of the soil test report or the owner's copy must be included. Mailing Address: Prey OwnetBlkN operty Locatf / ~sf~ ! } City, ill ge or To`wn_ship; County: t/a iT NiR E (or)® Lot Number: I oor- Subdivis ion Name: Neare t Road, Lake or Landmark: State Plan I. Number: "dr if (If assigned) TYPE OF BUILDING ❑ PP blic* ❑ Variance* El Other (specify)*~~ Number rooms: of L1S 1 or 2 Family *State Approval Required. GTOTAL ONUMBER PREFAB TANKS CONCRETE POURED-IN STEEL FIBERGLASS PLACE INSTALNEW LATION REPLACE- SEPTIC TANK CAPACITY M ENT E (Specify) HOLDING TANK CAPACITY LIFT PUMP TANK/SIPHON CHAMBER MANUFACTURER: EFFLUENT DISPOSAL SYSTEM PERCOLATION RATE ABSORPTION AREA (Minutes per inch): PROPOSED (Square feet): New ❑ Replacement ❑ Experimental IJd'Seepage Bed ❑ Seepage Pit ❑ Alternative (specify) ❑ Seepage Trench Water S ply: Owner's Name as Listed on Soil Test Report (If other than present owner): ate ❑ Jo int ❑ Public oe/ I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plume MP/MPRSW No.: Phone Number: is Add ess: (7 y signer: Jam. 03 IV I COUNTY/DEPARTMENT USE ONLY Signature of Issuing Agent_ F Date_: Sanitary Permit Number: : APPROVED Reason for Disapproval: ~ / El DISAPPROVED Alternate course(s) of Action Available: Change of ownership, building use or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to in- stallation. Failure to comply will void the sanitary permit. DISTRIBUTION: White-County, Canary-Bureau of Plumbing, Pink-Owner, Goldenrod-Plumber DILHR-SBD-6398 (R.07/81) Form - S T C 100 Owner of Property y ~l'Cr'i~GC Location of Property / 4&E ' Lq, Section T N R W ,246 Township , ~,.~.2~~►~a~G Mailing Address Subdivision Name Lot Number Previous Owner of Property . --Total Size of Parcel 3, Ip ~ Acces -Date Parcel Was Created 3&y\ q II ~I Are all corners identifiable? ~es No Include with this application one of the following: .Certified Surve Map + At, .Land Contract, or .Other I:egal Document which describes the property PROPERTY OWNER CERTIFICATION I (We) certify that all statements on this form are true to the best of my (our) knowledge; that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty d d record in the Office of the County Register of Deeds as Document Nod.-'7-,3 ; and that I (we) presently own the proposed site for the sewage disposal system (or I (we) have obtained an easement, to run with the above described property, for the construction of said system, and the same has been duly recorded in the Office of the County Register of Deeds, as Document No. SIGNATURE OF OWNER SIGNATURE OF COOWNER (IF APPLICABLEI CIR9 ATE 61 ED D E SIGN H cf~ . H Y S T C - 105 r y ' H SL PT LC TANK MAIN'T'ENANCE A(:kEEMEN'1' F-+ 0 SL. Croix County d OWNER/BUYER -e t ROUTE/BOX NUMBI:k F.i re Numb r C I T Y / S'I' A'I' E 7l. 1: P PROPERTY 1, 0 CAT10N:V .`iecL i~.~i I_!' -N, IZ_.le W, Town of ( !C St Croix County, Su1)div Lsioit Alo,-ty, -L Lot uumbel 1 I Lstpro1) er us0 urtd maintenance of your_ sel,t it system could result in its premature failure to handle wastes. Illoper maintenance con- sists of puslpittg out the septic Lank every Lill-ce yours or soouer., if needed, by a Licensed sel)tic tank 1)uml),er. What you put into the system aff(I t1,n of t: tic! se1)I- Ir tank as a treat - ment s tage lit the waste disposal sy:sL 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 L, 1-978. St. Croix County accepted this program in Auls,ust of 1980, wifill the requirement that owners of it1 l new yet..n:; )I,rt: e t n keel) tIIC' i_r systeuts proper I y maintained. The property owner agree.; Lt) subutiL to St. Croix County toning a certification form, sigucd by the owner and by a uta;ter plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying t hat (1) the ou-site wastewater disposal system is in proper Operating condiLion and (2) after insptet- Lion and pnntpi.ng (i.f neC- essary), the Septic tank is less than 1-/3 full of sludge and _;cum. Certification Corm will be sent approxi-stately 30 days prior to three year expiration. H 0 l/WE, the undersigned, have read the above re(Juirements -and agree U~ tic) maintain the private sewage disposal. system in accordance with r1 the standards set forth, herein, as set by the Wisconsin Depart- w went of Natural Resources. Certification corm must be completed grid returned to the St. Croix County 'l.oniug Office within 30 days OIL the throe year expiral. i~.n date. t t S 1 C N E U' `~}a 1► - - - - - - 1)ATE Q St. Croix County 'tun-Lng Office Y.O, lox 98 llammor d, W1 54015 7 1. 5- 7~ 6- 2 2 3 9 or 715-425-8363 Sign, date and return to above add r mwhcr truns~- s ~ncc~ mmmmim= 1 xSCCWM„ SANITARY PERMIT ~-DILHR County M GROUNDWATER SURCHARGE ~ WMUSTRV, LA MM 6 0-ft I F ELgT13xnMS Sanitary Permit No. 9 y 1,7 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 tank 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. Ground ato ( Wisco `S Signa re of Issuing A ent: Groundwa Fee: Date: DILHR SBD-7289 (N. 05/84) ° Ms, DEPARTM-NT OF REPORT ON SOIL BORINGS AND; SAFETY & BUILDINGS DIVISION INDUSTRY,# P.O. (SOX 7009 ti LABOR AND PERCOLATION TESTS (115) MADISON, WI 53707 HUMAN RELATIONS , (N63.09C11 & Chapter 145.045) f I' MUNICIPALITY: T B IVISION N M TT /T. 1 ~ ~BN~R~e E I ) ~c .e:', ti *i, +aul: ►tiir';" ' 0, 0 /4~ 4: • } COUNTY: S-NAME : s c. ,QO ~ c~E,.-~ E' ^'t S- o z c . r. . M v_~h` .,~,r, rK,it:~r~ ms's" - DATED 002rllVAftoNt NI1Aoa { t i a {y, ~Rssldence XNeW_ ❑Repleca ~i 's. 8• ; or ~Ie~►. . ~ ~ .r.,r' •r' ~~.-+L/j ratr~~~~,+,ilt&. ~'xs-+-r .r `i.. v:,.. , RATINO: Br late suitable for U- Ite~unaunable for ayatertt : Rfi M 8T o Ignal l „-,p If ~nl~pOt'ttO/t0{thrtaKet~MreN;~-4'7}(rMh.J 5 II Percolation Tnu ere NOT required. y i t,~', ,,j~,, , ,r `y . under s.H83.09(6)(b), indicate` G 4 S FloodPlaln,1ridlate Ploodplain,~lwe~lOrlq PROFILE DESCRIPTIONS,'•,'1; ) ° xc ~l' ^t 0 PING AL -IN H A S R_}- R AND-D, TH NUMBER DEPTH IN, ELEVATION T IF RV. GA ' y+ 4 % r, • "ka.,, .i: ~ ° kt: ~ ~"'~tr~ a~; Y.~nf 4 ra<" ne+v1~`r ^4 if'+~ r~~ B J2 ~z "a, B- 3' B-¢ °J_ / v dl ' PERCOLATION TESTS .a•G d ti c~.C' C t~ L:'O~+~l till'.. S d`,'~''~ / RAT Ml UT DR I A R V IN HE r ViLtER I OE H DEPTH A FTTER IN LL31 ILE TESVTIMEI 6 w r fvl P p , 7. P e ,~;..n" l 6.r e dfRulo&4 104;. Clbe ~vhat_at'a the N PLOT PLANt Bhow locations of percolation taste, soil borings and tfia dimensions of suitable soil arses, indicate ace direction end Pero zonal and vertical elevation reference points and show their Ioostion on the plot plan, dhow the, surf aaa a1e,VMtfan rill alfbo/EppLtMd f T,, F o of land slope. a SYSTEM ELEVATION ° T - - f- i II I , A i - AIL. I, the undersigned, hereby certify that the soil tests reported on this form were rtade by me in accord with the procedures and methods specified In the Wis Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge +and, belief ply .Tti, NAME print aJtn Y; CERTIFICATION. NUMBER: PHONE NV BER opts ADD S SIGNA U 5•-.qr._G Z ~ DISTRIBUTION; Original and one copy to Local Authority. Property Owner andySoll Test ()u HR SBD-6395 (R. 02/82) -OVER - ALL r t- • i i i C R t . t w y I ST E f I v~.rf ~ I 'G~ > 1.2 r r w!// 11 'A, y ~ 31 ~ •~1 ~ ~nr ~ ~ _ . ; _FT DER=MENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION P.O. BOX 7969 LABOR AND PERCOLATION TESTS HUMAN RELATIONS (115) MADISON, WI 53707 (H63.09(1) & Chapter 145.045) LOCATION: SECTION: - TOWNSHIP MUNICIPALITY: LOT N : BLK. N SUBDIVISION NAME: E /t, V4 - =s /T~=3N/R~a E c r, . .ti J~ ; . , G . COUNTY: (OWNER-' BUYER'S NAME: MAILING ADDRESS: ~T' i~~ix c r✓~G~ SCE%~ o F -'Vi'i-. G.. f-/. i ✓t ' ~ ~ USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: ©Residence XNew ❑Replace _ RATING: S= Site suitable for system U= Site unsuitable for system ECONVENTIONAL: D: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) flS DS EIU ~S []U US E U EIS IU i~k~ MFG r i/ r n 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 BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- V T / PERCOLATION TESTS _ TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD1 PERIOD2 PERIOD3 PERINCH P- (V F' - iU c-T a TF -C+ , P-cow P- P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION ~~-F~ l~.~ SF TT-4 G.~-/~.L-~ FYI -~k.t' ( I \ j , y E E x I A-11 %T i i - - 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: ,s, r✓ iz C. J Z~ - E3 - E3 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): CST SIGNATURE: l DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Test DILHR-SBD-6395 (R. 02/82) - OVER - ilk - - i~ it~t~a~e , in, f, -t" t asa :;ol - oo :il ,kc .tire? sel iC!E= i3~c [ ttl_; jai sd=} G"d Ei,r €C;, L1e-c'!it?(-ion and c>;~mplori igtfi"iE plctpl-~ , P%_r .a ti.. € lc3£,~"a-I a"~r,~rr,md v loca~tng your t --.st ,E.,cations. L. aVvi `iq to scale i, ~;3i'f'~F;~"-~ £,s (1251 if ,,i d ?r if,a1 :1owa i(.it, €C ii €viii(.; pL"Iif,1 a, Ci€,,a r i 3 ; cP ~'s:3r o i>t f a6' ."ox/k- ss 1n dt ig ',S, .tarn C eSlaw-! rr~f, , u1~Fi j.," Ot r~`a2 ~ s4 i.. 0;.?3 Y .Wid r'a, G#arr,- 'it1,`C` iii"1 r- l 4.7a °'`i ,..P(i,A3 ~i }eEa f 7 . utt s>,,;€ iut e°tc1 . Bi"Jdr 7 l i - ~i'4v o ;'N (t.; U # a ; - t.. S 10 1 c,,U 1 f " i Lh Dt~ llaft Ytt tit may rrr uest ts~ .i7 i~~i(3 r> for the )f~5•at p DE?AHTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR P.O. BOX 7969 LABO RELATIONS PERCOLATION TESTS (115) MADISON, WI 53707 (H63.090) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP MUNICIPALITY: LOT NO.: BLK. NO.: SUBDIVISION NAME: NE ~/4NEI/4 33 T28 N/RIB E(Or W KINNICKINNIC I C.S.M. COUNTY: WNER'S UYER'S NAME: MAILING ADDRESS: ST. CROIX EUGENE EMERSON R2 C.T.H. M RIVER FALLS WI. 54022 USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRISCRIPTIONS: E LATION TESTS: Residence New 84 5 - 29 - 84 FRS RATING: S= Site suitable for system U= Site unsuitable for system MIONAL: MOUND: IN-G~ROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional) ®S ❑ S~S Ou JOV ©U [JS ®U CONVENTIONAL 24X28 BED If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the under s.H63.09(5)(b), indicate: CLASS I Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- 1 7.3' 92.5 NONE > 7.3' 01s 11.9') BsI(2.3') BnIs 13.1') B- 2 6.5' 92.9 I+ 7 6.51 B n $ l 6.5 1) 3 6.8 93.6' 6.8' Bn s 1 1.6') 8n s I (1.1') Bn Is 14.1' ) B- B_ q 6.61 95.5 ) 7 8.6' an 1 I 1 ;9') Bn I s ( 6.7') B- 5 10.1 97.2' 11 7 10,1 Bn1f 3. 3') 9nIsf 8.8') B- .4~ Si~F T PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD I P_ERIOD2 PERIOD PER INCH P- 1 2.3' 10 41/2 5 1/2" 5" 2 p- 2 2.7' St 10 51. 5 9/16" 4 3/4" 2 P- 3 3.4' gPN 10 4 7/8" 4 1/ 2" 5 1 /16" 2 r P- P- P- PLOT PLAN: Show locations of percolation tests, sgil. 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. A 90.2' SYSTEM ELEVATION 8.90.8' A,SCA@E I E POIT REF. LfNE SEE I I BACKHQ TOP PIPE! r pPERC HOLE ASSUMED 100. LE ASSUMED 100' 235 t Iu IRON r l!' PROPERTY LINE( m m t y i I 30' I'w BI 30' B`2 _ _ ! p P,I P21 NOTE SAND HAS BEEN ST (RIPPED FROM TOP OF TEST AREA FOR THAT SOME A LOGS HAVE OOEHN BURIED N UPPER AREAS Of SUITABLE AREA I P3 (75 X 30) 2250 SO. FT. tD SOIL PROFILE HbWEVER SYSTEM IS 'SET, IN a 1 - UNDISTURBED AREA BELOW T14 it let 85 i' L -_j . I N SOME GRADING` MAY BE NECESSARY I , 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: LAURENCE W. MURPHY 5 - 30- 84 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): 314N2NDST.RIVER FALLS W1. 54022 55-2445 715425-9032 CST SI NATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Test i DILHR-SI SID-G'195 (R-0?!R?) OVER