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HomeMy WebLinkAbout030-2031-30-000 r n ca C , -J C; d M O J C': v v rr m 3 v _ - O r_r o C 1 N N _ CAD { A G O 0 O C f0D S O @ O Ut N C , ~ 3 p C) U_ D v> < n CD (D (D n O. ca w CD ~ a. o o ~ c - I'D J, m rn N "*MIA a C C (O C, U7 A C v -O ~ !V C.> Q C) ln' S N C D r> v v U - °o A 0 CD n lV O O N IN co 4- Z) CD ~a Ol N N o D Cp c O n n Q Z m - o ' ~ co I L7 ~ v ~ i - n 0- , Z h~ ° Z CD D z 0 (a N W -0 w w (D (D O O J z M > w ~ r N. G O c:l On 0 N n cl) (D N O _ "'01) (D (n j' Ci Ot O Q p Z (D N (J7 n W ~n n0 Om N O cn C N Q p O p =3 4 O (0. T ft, N _ co Q. O N i Z (D O C7 3 R Z C A f = Z co N _C)mN Jq A O N •P (D 7 i? y ~ iO ! O p as 02/24/2005 10:58 AM PAGE 1 OF 1 Parcel 030-2031-30-000 Alt. Parcel 23.30.20.4466 030 -TOWN OF SAINT JOSEPH ST. CROIX COUNTY, WISCONSIN Current X Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Owner(s): Current Owner Tax Address: " MOELTER, KEVIN G &JANICE G KEVIN G & JANICE G MOELTER 1473 ANDERSEN SC'T CP RD HOULTON WI 54082 Primary Districts: SC = School SP = Special Property Address(es): Type Dist # Description ' 1473 ANDERSEN SCOUT RD SC 2611 SCH D OF HUDSON SP 17ii0 WITC Legal :;e iption: Acres: 20.460 Plat: N/A-NOT AVAILABLE SEC 23 T'~.CN R20W NW NE COM N 1/4 COR SEC Block/Condo Bldg: 23 TH S 643.88 FT -POB TH S 672.91 FT TH S 89DEG E 1325.84 FT TH N 672.91 FT TH N Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 8gi~_:C' 324.82 FT -POB 23-30N-20W Note: Parcel History: Date Doc # Vol/Page Type 07123/1997 663/592 r Bill Fair Market Value: Assessed with: i. s .o~~RY 5973 Use Value Assessment Last Changed: 07109/2004 ValUatlt"''si5: Class Acres Land Improve Total State Reason D;:scriptitzl RESIDENTIAL G1 1.460 59,000 379,600 438,600 NO 11.000 1,700 0 1,700 NO AGRICULTURAL G4 8.000 49,200 0 49,200 NO PRODUCTIVE FORST LANC G6 General Property 20.460 109,900 379,600 489,500 Woodland 0.000 0 0 o, 2003: General Property 20.460 51,500 283,500 335,000 Woodland 0.000 0 0 Batch 160 LOtiery re, dlt: Claim Count: 1 Certification Date: r Category Amount U_. ,vue Special Assessments Special Charges Delinquent Charges 0.00 0.00 Total 02/24/2005 10:58 AM Parcel 030-2031-20-000 PAGE 1 OF 1 030 Alt. Parcel 23.30.20.446A - TOWN OF SAINT JOSEPH ST. CROIX COUNTY, WISCONSIN Current X Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Owner(s): * = Current Owner Tax Address: * MOELTER, KEVIN G &JANICE G KEVIN G & JANICE G MOELTER 1473 ANDERSEN SC'T CP RD HOULTON WI 54082 * =Primary Districts: SC = School SP = Special Property Address(es): Type Dist # Description * 1473 ANDERSEN SCOUT RD SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 16.290 Plat: N/A-NOT AVAILABLE SE -7 23 T30N R20W NW NE EXC P446B AS IN Block/Condo Bldg: 663'592 AND EXC P446A-10 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 23-30N-20W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 887/600 07/23/1997 854/208 07/23/1997 850/163 20u' , S L ;A 11 l RY Bill Fair Market Value: Assessed with: 5971 Use Value Assessment Last Changed: 07/09/2004 va±uatl%s`1S: Improve Total State Reason Descriptions Class Acres Land Land 0 1,400 NO AGRICULTURAL G4 9.000 1,400 0 30,600 NO PRODUCTIVE FORST LANC G6 6.290 30,600 4,400 26,200 NO OTHER G7 1.000 21,800 General Property 16.290 53,800 4,400 58,200 Woodland 0.000 0 0 ` ` L003' General Property 16.290 29,200 4,400 33,600 Woodland 0.000 0 0 Batch LO~:ery Credit: Claim Count: 0 Certification Date: Amount Category Usv, Code Special Assessments Special Charges Delinquent Charges • 0.00 0.00 Total 0.00 Parcel 030-2031-20-110 02/24/2005 11:26 AM PAGE 1 OF 1 Alt. Parcel 23.30.20.446A-10 030 - 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): Current Owner GERMAIN, DALE M & JANIE L DALE M & JANIE L GERMAIN 1497 ANDERSEN SC'T CP RD HOULTOP! WI 54082 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 1497 ANDERSEN SCO$- SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 3.250 Plat: N/A-NOT AVAILABLE SEC 23 T"ON R20W PT NW NE LOT 1 CSM Block/Condo Bldg: 8/2293 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 23-30N-20W Notes: Parcel History: Date Doc # Vol/Page Type 10/28/1998 590109 1370/430 WD r , ~-Y-1~ R) 07/23/1997 854/208 2J0 S"I NI . ARY Bill Fair Market Value: Assessed with: 5972 458,700 Valuati: ti Last Changed: 07/09/2004 D::scripticrn Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.250 76,700 374,600 451,300 NO 4: General Property 3.250 76,700 374,600 451,300 Woodland 0.000 0 0 otals ; 2003: General Property 3.250 45,100 278,400 323,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 220 U<<-, 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 !k. TOWNSHIP i r. SEC. 7 T 3U N-RW W ADDRESS ST. CROIX COUNTY WISCONSIN SUBDIVISION LOT ~3ca LO SIZE PLAN VIEW Distances and dimensions to meet requirements of H 63 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM R INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used Elevation of vertical reference point: Proposed slope at site: SEPTIC TANK: Manufacturer: Liquid Capacity: Number of rings used: Tank manhole cover elevation: 97,a5' S: G Tank Inlet Elevation: Tank Outlet Elevation: Number of feet from nearest Road: Front,v--ISide10 Rear, C) J`J r feet From nearest property line Front, 0Side, 0Rear, 0 feet Number of feet from: well ;1 building: (Include this information of the above plot plan)( 2 reference dimensions to septic tank) r PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: -----Pump Size Elevation of inlet: Bottom of tank vation: Pump off switch elevation: :.-Gallons per cycle: _ Alarm Manufacturer: i Ala~ itch Type: Number of feet from rfearest property line: Front, Si Rear, 0 Ft. Number of feet from well: % Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: Width: rfi Length: Number of Lines: Area Built: Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side, 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 Rc-ax_, OFt. Number of feet from well: Number of feet from building: Number of feet from nearest road: L Alarm Manufacturer: Inspector: 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, W)+53707 1-X CONVENTIONAL El ALTERNATIVE State Plan 1D. Number (If assigned) El Holding Tank El In-Ground Pressure El Mound NAME OF PERMIT HOLDER: ]ADDRESS OF PERMIT HOLDER: INSPECTION DATE. Kevin Moette)e R. R. 1, St. Joseph, W1 54082 T-A 7 -k BENCH MARK (Perrnanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.: CST REF. PT. ELEV.. NW NE, Section 23, T30N-R20W, Town o6 St. Joseph Na,- of Plumber MP/MPRSW No. County. Sanitary Permit Number'. Don Schmitt 3205. Cna~x 49491 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV.. WARN NG LABEL LOCKI V 1 P V ED PROV E C uAl o~c I~' YES El NO NO BEDDING: VENT CIA, VENT MATL. HIGH WATER NUMBER OF ROAD'. PROPERT WELL. BUILDING: 1VE TO FRESH " ALARM. FEET FROM 1 L~ INE' I Y AIR INLET. OYES ONO C/ DYES ONO NEAREST 5 yl~J' DOSING CHAMBER: MANUFACTURER BEDDING. LIQUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER PROVIDED'. PROVIDED'. OYES ONO OYES ONO OYES ONO GALLONS PER CYCLE: PUMP AND CO VrnoLS OPERATI ONAL NUMBER OF PROPERTY WELL BUILDING I VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET PUMP ON AND OFF) OYES NO NEAREST----~ SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing EN(4TH 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: BED/TRENCH WIDTH LENGTH NO OF DISTR PIPE SPACING COVER JI NSIUE DIA -PITS LIQUID i p TRENCHES M HIAL' PIT DEPTH. DIMENSIONS 1 {C~' GRAVEL DEPTH FILL DE TH UISTR PIPE DISTR PIPE DISTR. PIPE MATERIAL NO. D R NUMBER OF PROPER TV WELL. BUILDING: VENT TO FRESH BE LOW PI C_ AC~,ER ELEV INLET ELEV END PIPES LI AIR INLET. FEET FROM NEAREST--i► 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- O YES NO meets the criteria for medium sand. TIONS MEASURED. O SOIL COVER TEXTURE PERMANENT MARKERS JOBSERVATION WELLS OYES ONO EYES ONO DEPTH OVER TRENCH.BED DEPTH OVER TRENCH,BED DEPTH OF TOPSOIL SODDED SEEDED MULCHED CENTER EDGES. OYES ONO OYES ONO OYES NO 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 MATEHIAL & MARKING ELEV.. ELEV.. CIA ELEV.'. PIPES CIA ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS EYES ONO OYES ONO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: FEET FROM LINE OYES NO OYES ONO NEAREST J SL- Sketch System on - etain P"adunty file for audit. Reverse Side. GNATU TITLE DILHR SBD 6710 (R. 01/82) ~ wls~onsln APPLICATION FOR SANITARY PERMIT (PLB 67) ~ t'~~4 COUNTY ~ DILHR aERRRTfT1FnTOV UNIFORM SANITARY PERMIT # Inc3USTRV, LRBOR 6 "1JMRn RELRTIOnS -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 MAILING ADDRESS C /c`z L" PROPERTY LOCATION CITY: l VILLAGE. r - 1/4 L 1/4, S T: 36 N, R ' CE (or) M-),,: Of LOT NUMBER JBLOCK NUMBER SUBDIVISION NAME EST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER A < - TYPE OF BUILDING OR USE SERVED . ~O c/wl ao, i 11 or 2 Family Number of Bedrooms. j Public (Specify): //A 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. E 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 l 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 Gallon Tan Concrete Constructed Septic Tank Capacity Lift Pump/Siphon Chamber Manufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): Ly Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumber (Print): Sign ufe: M MPRSW No.: Phone Number: r (?i5") Plumber's Address: Name of Designer: COUNTY/DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: ❑ Disapproved s / ❑ Owner Given Initial U f~ f Approved Adverse Determination ~ 0 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 STC - 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/contractRV,("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 ~V, Location of Property '/E ' Section T 1 N - R'' Township `3 'j Mailing Address Subdivision Name Lot Number AI Previous Owner of Property Total Size of Parcel U?° Date Parcel was Created Are all corners and lot lines identifiable? x Yes No Is this property being developed for resale (spec house) ? Yes- No Volume and Page Number j F!2.2 a~, --corded witti 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 I (We) eettI 6y that aU staterr,"en ,6 on this 6onm ate tA.ue to the best o6 my (out) k.nowtedge; .that I (we) am (ane) the owneA (s) o6 the ptopenty densembed in -thus insonmati..on 6o4m, by v-iA,tue o6 a wat anty deed teeoaded to the 066ice o6 the County Regis teA o6 Deeds as Do eumen t No. ' . ; and that 1 (we) pne/sentty oun the pnoposed site bon the sewage di6posat sy.Stem (on I (we) have obtained an easement, to nun with the above deg ct bed pnopercty, bon the eonsttuction ob said system, and the -same has been duty neeotded in the 066ice of the County Regis,tet o6 Deeds, ab Document No. SIGNATURE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED r1 . y S T C - 105 r . ;Y r-j SEPTIC TANK MAINTENANCE AGREEMENT ~ 0 St. Croix County 0 O W N E R / B U Y E R C /IV FLEA ROUTE/BOX NUMBER_-~~ Fire Number r t CITY/STATE Lr PROPERTY LOCATION: /Y10. I/& . Sercliuu ~~j 1, 7C' N, R~CC 1'~>wn uf, /~St Croix County, S u b d iv is ion - / Lot number fkoj-. I Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumpLng Out the septic tank every three years or sooner, if needed, by a 1 ie ensed s_c pL_ic tank pumper. What you put into the system can affect the function of the septic tank as a treat- went stare Ln the waste disposal System. St. Croix County residents may be eligible to receive a graiet 101- a maximum of 60% of the cost of replacement of a failing system, which was in uperat ion prior to July 1, 1978. St. Croix County accepted this program In A"gust of 1980, with the requirement that owners of all now 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 vcri- ly1_ng that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (Lf nec- essary), the septic tank is leas than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. ~s 0 l 1/WI?, the undersfl;nc_ci, have read the above requirements and agree to maJntaLn the private sewdge disposal system in accordance with r, the standards set turth, herein, as set by the Wisconsin Depart- w went of NaLuraL Resources. Certification form must be completed ~ and returned to the St. Croix County `honing Office withLn 30 clays of the three yecar expiry-etLuu dale. S 1 CNE1) 1) ATE St. Croix County Zoning Ullice Y.U. Dux 98 Hammond, W1 54015 715-796-2239 or 715-425-8363 Sign, elate and return to above address. DEPAIV.MENT OF TRY', , _ ICJD UST R 1 REPORT ON SOIL BORINGS AND aM ~ FAT &..BUILDINGS %VSION 'LA?BOR'AND PERCOLATION TESTS (115) 1 53707 HUMAN RELATIONS I ~C P. DI X HUMAN 3707 • (H63.09(1) & Chapter 145.045) 1!3 P* LOCATION: SECTION: p TOWCNSy-HIP/A41~A}F£+P~tL-I-1-4 ; LOT NO.: BLK. N UBDIV ~v a 3 /T30N/R "F~o p (or J A ~ ' COUNTY: OWNER'S/BUYER'S NAME: MAILING ADDRESS: S T ~r©,` ~c ~ c% r e,u C r oo Box ~ w y ~3S' ~ ltJ,s , ~al~ USE DATES OBSERVATI M E ~ LAResidence NO. BEDRMS,: COMMERCW ESCRIPTION: PROFILE DESCRIPTION LATION TESTS.3 t New❑Replace t/-.23- I./ ` A~ RATING: S= Site suitable for system U= Site unsuitable for system G, 3 3 Aa/,1e0 .5-,` aA CONVENTIONAL: MOUND: IN-GROUND-PRESS URE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional) ®S DU ®S~ ®S❑U ❑S®U ❑SZU If Percolation Tests are NOT required DESIGN RATE: If an y portion the tested area is the under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL, ELEVATION DEPTH TO GROUNDWATER4d61-FE8 CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH4# OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- 2 Leo' 9A/W~ o` B- 0' ~16r y' ,<IQ,u > 7 0 B- 7•o' y6, dolae- ? 70f , Y .l3(l O• Y e- , 6 &S-14 3= G,'n S- B- tr' 7, o` o' . Y k'l l B- PERCOLATION TESTS TEST DEPTH-l' WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER ^~+H AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD 3 PER INCH P- n Z C 3 L_ 3 P- 3 3,6' ° d2 3 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 1 of land slope. CIIA ie SYSTEM ELEVATION 93.9 ' e c, e,-- d GIE---- 3 6' -a _ J"4 Xe, 14~c s, C, /.6 7 to, r2 ~o Pie) ~o ~ ~ ~SSunse ~ F,l, = boo. o ` I A ,C! ores (Akht) N O fe e s ( Test 6c j9(rti E!. = / I J 61 4re g Ap- site/ - orA~cGe,~ S f~le- fi1wy 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: {/I~If/ki S r /L/'•I b 066 ,5--,2 - J0_3 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): h1ve, 31& - S?/ CST ! TUBE: . DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/£32) - OVER ~v Ci'1 tip o; ~E N S. r u io n a ='~*t _ r> 1 c 3j .3 aF ~S r r~ . mat ~ r a v R "up Y'. 3 r £ c c rt , ,y, ~s s t rl 1 i 7, E~jt 2 I e 'WI t l N n~ r ~ 1. -5 Ell ALT , r t 779f )3 ~o rof' r g~ Sr j=5/ycG fey lei ja r ,71t 1 y Cis c / D tt1.1 c ,?y i / n M i ~ ~ ` , = ~ ~ ~ ;;'fir ~ ~ ~5~~~/~'S~~ C~ ~i ` ~ jc