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Parcel 030-1010-20-000 10/24/2005 09:24 AM
PAGE 1 OF 1
Alt. Parcel M 03.29.19.49B 030 - TOWN OF SAINT JOSEPH
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 - ORF, ROBERT & SHIRLEY
ROBERT & SHIRLEY ORF
603 RIVER RD
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description " 603 RIVER RD
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 2.750 Plat: N/A-NOT AVAILABLE
SEC 3 T29N R19W N 300 FT OF W 400 FT OF Block/Condo Bldg:
NW SW
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
03-29N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
2005 SUMMARY Bill M Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07/07/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.750 71,300 111,500 182,800 NO
Totals for 2005:
General Property 2.750 71,300 111,500 182,800
Woodland 0.000 0 0
Totals for 2004:
General Property 2.750 71,300 111,500 182,800
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 314
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Parcel 030-1010-20-000 12/30/2005 07:40 AM
PAGE 1 OF 1
Alt. Parcel 03.29.19.49B 030 - TOWN OF SAINT JOSEPH
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 - ORF, ROBERT & SHIRLEY
ROBERT & SHIRLEY ORF
603 RIVER RD
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): * = Primary
I
Type Dist # Description 603 RIVER RD
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 2.750 Plat: N/A-NOT AVAILABLE
SEC 3 T29N R19W N 300 FT OF W 400 FT OF Block/Condo Bldg:
NW SW
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
03-29N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
2005 SUMMARY Bill Fair Market Value: Assessed with:
83169 201,000
Valuations: Last Changed: 07/07/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.750 71,300 111,500 182,800 NO
Totals for 2005:
General Property 2.750 71,300 111,500 182,800
Woodland 0.000 0 0
Totals for 2004:
General Property 2.750 71,300 111,500 182,800
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 314
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Parcel 030-1010-10-000 12/30/2005 07:41 AM
PAGE 1 OF 1
Alt. Parcel 03.29.19.49A 030 - TOWN OF SAINT JOSEPH
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 - ORF, ROBERT & SHIRLEY
ROBERT & SHIRLEY ORF
603 RIVER RD
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 37.250 Plat: N/A-NOT AVAILABLE
SEC 3 T29N R19W NW SW EXC N 300 FT OF W Block/Condo Bldg:
400 FT 37.250 ACRES
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
03-29N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 802/302
2005 SUMMARY Bill Fair Market Value: Assessed with:
83168 Use Value Assessment
Valuations: Last Changed: 05/31/2005
Description Class Acres Land Improve Total State Reason
AGRICULTURAL G4 7.570 1,100 0 1,100 NO
UNDEVELOPED G5 0.680 200 0 200 NO
ENTERED BEFORE 2005 OPE W7 11.000 14,700 0 14,700 NO
ENTERED BEFORE'05 CLOSE W8 18.000 24,400 0 24,400 NO
Totals for 2005:
General Property 8.250 1,300 0 1,300
Woodland 29.000 39,100 39,100
Totals for 2004:
General Property 8.250 1,400 0 1,400
Woodland 29.000 78,200 78,200
Lottery Credit: Claim Count: 0 Certification Date: Batch
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Parcel 030-1009-50-000 12/30/2005 07:41 AM
PAGE 1 OF 1
Alt. Parcel 03.29.19.46 030 - TOWN OF SAINT JOSEPH
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
ROBERT & SHIRLEY ORF O - ORF, ROBERT & SHIRLEY
603 RIVER RD
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE
SEC 3 T29N R1 9W SW NW 40 ACRES Block/Condo Bldg:
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
03-29N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 802/302
2005 SUMMARY Bill M Fair Market Value: Assessed with:
83163 0
Valuations: Last Changed: 07/07/2004
Description Class Acres Land Improve Total State Reason
ENTERED BEFORE'05 CLOSE W8 40.000 115,400 0 115,400 NO
Totals for 2005:
General Property 0.000 0 0 0
Woodland 40.000 115,400 115,400
Totals for 2004:
General Property 0.000 0 0 0
Woodland 40.000 115,400 115,400
Lottery Credit: Claim Count: 0 Certification Date: Batch M
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
ppr,
C C - 104 '
AS BUILT SANITARY SYSTEM REPORT
OWNER TOWNSHIP SEC. ~
ADDRESS ST. CROIX COUNTY, WISCONSIN
j i
SUBDIVISION LOT ; LOT SIZE
PLAN VIEW
Distances and dimensions to meet requirements of H 63
t
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
i
i
i
Ir
r
1 ~ r t'r ~ r
Ii
/ INDICATE NORTH ARROW
BENCHMARK: Describe the vertical reference point used 1j,;z
Elevation of vertical reference point: Proposed slope at site: /
f l
SEPTIC TANK: Manufacturer /j.-, Y Liquid Capacity:
Number of rings used: Tank manhole cover elevation:
Tank Inlet Elevation: Tank Outlet Elevation:
Number of feet from nearest Road: Front, Side,0 Rear, 0 i-%
i feet
From nearest property line Front,0 Side,0 Rear, z feet
Number of feet from: wellfi building:
(Include this information of the above plot plan)( 2 reference dimensions to septic tank)
SEE R}~;VI?ItSR SIDE:
r
PUMP CHAMBER
Manufacturer: Liquid Capacity:
Pump Model: Pump/Siphon Manufacturer: Pump Size
Elevation of inlet: Bottom of tank elevation:
Pump off switch elevation: Gallons per cycle:
Alarm Manufacturer: Alarm Switch Type:
Number of feet from nearest property line: Front, O Side, O Rear, 0 Ft.
Number of feet from well:
Number of feet from building:
(Include distances on plot plan).
SOIL ABSORPTION SYSTEM
Bed: Trench:
Width: Length: Number of Lines: Area Built: Fill depth to top of pipe:
Number of feet from nearest property line: Front, O Side, O Rear,O Ft.
Number of feet from well:
Number of feet from building:
(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:
Inspector:
J
Dated:~' _ Plumber on job:
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
MADISON, WI 53707
CONVENTIONAL ❑ALTERNATIVE State Plan 1D. Number
(If assigned)
❑ Holding Tank ❑ In-Ground Pressure ❑ Mound
NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER'. INSPECTION DATE'.
Bob Orf R. R. 2, Hudson, WI I Q
BENCH MARK Fermanem reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.: CST REF. PT. ELEV.
NW SW, Section 3, T29N-R19W, Town of St. Joseph
Name of Plumber. j"P/MPHSW No. Cooney Sanitary Permit Number'.
Cal Powers 1563 St. Croix 54924
SEPTIC TANK/HOLDING TANK:
MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV.. WARNING LABEL LOCKIN C EP
r„ P DED: PROMD /
YES ❑NO YESs [-]NO
BEDDING: VENT CIA 7MATL. HIGH WATE NUMBER OF ROAD: PROPERTY WELL. BUILDING: IVENT TO FRESH
ALARM LINE. AIR T T
FEET F
❑YES O Ir ❑YES O NEARESTOM 0
DOSING CHAMBER: J
MANUFACTURER BEDDING. LIQUID CAPACITY PUMP MODEL TPUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER
PROVIDED: PROVIDED.
❑YES ❑NO ❑YES ❑NO ❑YES ❑NO
JPUMP AND CONTROLS OPERATIONAL. NUMBER OF PROPERTY WELL BUILDING VENT TO FRESH
GALLONS PER CYCLE: NE I AIR INLET
(DIFFERENCE BETWEEN _ FEET FROM
PUMP ON AND OFF) ❑YES NO NEAREST
SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing k Ncnl 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:
WIDTH. ILINGTH(_ NOPIPE SPACING; COVER NSIDE DIA-PITS LIQUID
DEPTHDIMENSIONS r
BED/TRENCH TRENCH.. ~ I1RIA ±NEAREST
GRAVEL DEPTH FILL DEPTH DISTR PIPF DISTR PIPE DISTR. PIPE MATERIALNO. ISTH R OF ERTY WELLBUILDINGVENTTOFRESH
BELQWPIPFS! ABOVE COVER ELEVNLET ELEVEND PIPE ROM AI INT7 Z Z J
MOUND SYSTEM:
Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM
and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA-
meets the criteria for medium sand. TIONS MEASURED.
❑YES ❑NO
SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS
❑YES ❑NO ❑YES ❑NO
DEPTH OVER TRENCH .'BED DEPTH OVER TRENCH: BED DEPTH OF TOPSOIL SODDED SEEDED MULCHED
CENTER EDGES
❑YES ❑NO ❑YES ❑NO ❑YES ❑NO
PRESSURIZED DISTRIBUTION SYSTEM:
WIDTH. LENGTH NO. OF LATERAL SPACING. GRAVEL DEPTH BELOW PIPF. FILL DEPTH ABOVE COVER
BED/TRENCH TRENCHES.
DIMENSIONS
ISTR. PIPE DISFRIBUTION PIPE MATERIAL & MARKING.
MANIFOLD PUMP MANIFOLD DISTR. PIPE 7T7
ELEV. ELEV DIA ELEV IA.:
ELEVATION AND
OV ED
DISTRIBUI ION VERTICAL LIFT CORRESPONDS TO APPR
INFORMATON HOLE SIZE HOLE SPACING DRILLED CORRECTLY PLANS
❑YES ❑N[:]YES NO
JERVATIOUMBER OF P ERTV WELLBUILDING'.
COMMENTS: PERMANENT MARKERS: OBS LIRNEOP
EET FROM
❑YES ❑NO ❑EARES-r-----~(
.
l•
Sketch System on ,Rain in county file for audit.
Reverse Side. TITLE
,
SIGNATURE'. .
`
DILHR SBD 6710 (R. 01/82)
ter WISCOnsln APPLICATION FOR SANITARY PERMIT
~ ®I L H R (PLB -~COUNTY
oEggqT 'EnT of UNIFORM SANITARY PERMIT #
- - InouSTRV, LREIOq 6 HUMRn RELgTIOnS
-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
PROP.5RTY OWNER MAILING ADDRESS
PROPERTY LOCATION CITY: f
S N, R (or CN VIwN OF: J.!
.i
LOT NUMBER BLOCK PJUMBER SUBDIVISI N NAME AREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER
TYPE OF BUILDING OR USE SERVED /LD• 0 -'j/O-lQ ~d
1 or 2 Family Number of Bedrooms: < ` ❑ Public (Specify):
THIS PERMIT IS FOR A:
NIP`"' 1"r°" Tank Replacement ❑ Repair
Replacement Soil Absorption System
❑ Privy
Alternate ystem L~ Reconnection ❑ Petition for Modification
IF T ENTIONAL SYSTEM COMPLETE THIS BLOCK.
Ei~ 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
Holding Tank capacity
Manufacturer:
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 t "
Lift Pump/Siphon Chamber
Manufacturer:
PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY:
(Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet):
Private ❑ Joint ❑ Public
I, the undersigned, hereby assume responsibility for installation f the private sewage system shown on the attached plans.
Na of Plumber (Print): Si atu e MP/MPRSW No.: Phone Number.
, W'6~~
Plumlpgrs Address: %r N7ae of Designer:
COUNTY/ DEPARTMENT USE ONLY
Signature of Issuing Agent: Fee: / late: O ❑ Disapproved
/ p u y Approved Owner Given Initial
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 PI?RMl`I'
S T C - 1.00
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 b owner/contractor "
y , ( 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 Section T, N - R W
Township Z--
Ma il ing Address
ItLGC~Son~ 61T S`f0 f lv
Subdivision Name
Lot Number
Previous Owner of Property
Total_ Size of Parcel
Date Parcel was Created
Are all corners and lot lines identifiable? Yes No
Is this property being developed for resale (spec house) ? Yes!
Volumeand Page Number as recorded with the Register of Deeds
INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING:
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 decd description references to a Certified Survey
Map, the the Certified Survey Map shall also be required.
PROPERTY OWNER CERTIFICATION
I (We) cehtj )y that oeX 6 tatement/5 on the ~onm aAe ti.ue to .the. bent oA my (OLO )
Iznowecdge; that I (we) am (ace) the ownm (6 y de~senibed 'n this
i~s
in*,,cmatton Aonm, by viihtue, o{ a waAAan . deed necmded s he O{Oice oo .the
County RegiA~~e~c o{ Dee.ds r~, Document N D~~D avid that I (we)
a> e,wntty own the- pnopo6ed Ate Aon t e_ - y~stem km I (we) have.
obtained an eaAeme.nt, to nun with the above de~eAibed pnopehty, {ion the
conAthucti_on o{ /said 5yb.tem, and the bame. haA been day neeonded in the O{(Jice
o6 .the County Reg.6ten oA aee.d~, a,~ Doeume.nt No.
SIGNATURE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE)
DATE SIGNED DATE SIGNED
' y
r
S T C - 105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
c~
y
OWNER/BUYER-
ROUTE/BOX NUMBER -Fire Number.
CITY/STATE Z 1P
PROPERTY LOCATION: IL, _~~~4, Section N, R W,
S"
Town of err/-- St. Croix County,
Subdivision Lot number
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 syvaer,
It needed, by a licensed septic tank p_umLer. What you put into
the system can affect the function of the septic tank as a treat-
meat 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 stems 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-
lying that (l) 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.
I/WE, the undersigned, have read the above requirements and agree U)
to maintain the private sewage disposal system in accordance with H
the standards set forth, herein, as set by the Wisconsin Depart-
ment of Natural Resources. Certification form most be completed
and returned to the St. Croix County Zoning 0flice within 30 days
of the three year expirat.iou"date.
vSTCNEDdC(.'
- - -
U ATE
St. Croix County Zoning Oftice
P.O. Box 98
Hammond, WI 54015
715-796-2239 or 715-425-8363
Sign, date and return to alcove address.
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY&BUILDINGS
INDUSTRY,'
LABOR AND P.O. BOX 7969
PERCOLATION TESTS ( / 115l DIVISION
HUMAN RELATIONS (H63.090) & Chapter 145.045) \ MADISON, WI 53707
LOCATION: SECTION: TOWNSHIP/MMICIP,ALITY: LOT NO.: BILK. 0.: SUBDIVISION NAME:
_ /
17/44, IY4
COUNTY: OWNER'S/B YER'6 NAME: MAILING ADDR SS: J ,
r". Q
USE
NO. BEDRMS.: COMMERCIAL DESCRIPTION: DATES OBSERVATIONS MADE
Residence - (PROFILE DESCRIPTIONS: PERCOLATION TESTS:
New Replace
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENTIONAL: MOUND: IN-GROUll,1 11 SU 11 SYSTEfVI IN-FILLHOLDINGTANK: RECOMMENDED SYSTEM (optional) /
MS ❑u os ou PAIS ❑u as du ❑s u
If Percolation Tests are NOT required% DESIGN RATE:
under s.H63.09(5)(b), indicate: If any portion of the tested area is in the
r f [Floodplain, indicate Floodplain elevation:
r PROFILE DESCRIPTIONS
BORING ` TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTHfiN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
B-
B-
B- -
B-
B-
PERCOLATION TESTS
_-TE-ST DEPTH WA ERIN TIM NUMBER INCHES AFTERSWELOLING INTERVA MIN. DROP IN WATER LEVEL-INCHES
RATE MINUTES
PERIOD 1 PERIOD 2 PERIOD 3 PER INCH
P-
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
t
t --I-
r
t
TN
r t
_ _ I l
1 I t
i
i
E
- - - -
7 € t
1~ {
I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procId re a
Administrative Code and that the nd m~ds specified in the Wisconsin
c ^ ^'-`l
data recorded and the location of the tests are correct to the best of my knowledge belief.
NAME-1print):
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Fresh Au Inlelb And Obcervallon Pipe
- - Approved Vent Cop
Minimum 12" Above
Final Grade
2U- 42" Above Plpe _ 4" CoU iron
To Final Grode Vent Pipe
Mores Hoy Or SynlMllc Co sring
.In 2" Aggregate
Over Plpe
OlurlbuNon
Pipe - 0 0 0 0 0 - Tee
G" Aggregate
Beneath Pipe ° Pertoroled pip* Below
0 _Coupling Terminating AI
Bottom 01 Syhtem
~LIeJ•~ r tort
SOIL FILL
DISTkIBUTIOF.I PIPE
APPROVED SI NTHETIC COVER
2" AGGREGATE 'MATERI^t OR q" OF STRAW
OR MARSH {-IAy
OF%z AGGREGATE.
ELEV. OF..ZZ, FEAT--._
DISTRIF~UTIOU PIPE TO EF AT LEAST ICHES BELOW ORIGiQAL GRADE
AQL) AT LEASTZO ICHES BUT 1.10 MORE THAN tit iUCHES ®LLOW FINAL GRADE
MAXImum ®EPTH OF EXcAVAT100 FX011 OKiGw+AL &XApa WILL BE `50 FICHES -36 MIMMUM Mfrtt OF EACAVATION FKOM C4~16►wAL CRADI= WILL BE _ INCHES
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DATE
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