Loading...
HomeMy WebLinkAbout040-1017-70-000 ,c n N p 3 (7 d ~l o y c w r c o m 3 3 3 Z v :I o o <D a st c r: cn _ :T CO a, 3 0 m co n ° N° 0-4 z n m cn 00 ~AC ID N N w o y O V CL O n C) p fD O n O f C O ' a p = O O 3 O0 ti N C ~ C7 D a T (D CD Cn N W a w m C C _ n I~ N 3 a O O N V CD CD C~ CL o 4 ~ a 00 !r • 0 S 3 o DZ OIC,- v O a cn 5, CD 7 N (D ID 4, C) N O : Ul (D w m N) 0 ~ CD Q. N N Cil n. D Co z O CD CL o b c m C/) • (D -0 N (~y~ w N ~f C D N O 0. a 3 a m cO Cl) Z v n a Z o a' z-i41. C CD m 00 CL z 0 3 X m m co z ~ CD ~ I w w N p am n Q co a a. `o v s m T w N oz d (D co m CD C o w o o ~ 17 30 a D C/) K (D v aw Lnn N c ti N o 0 I a A O~ N CD 4 C \ Q * O O0 i b Parcel 040-1017-70-000 07/21/2006 11:49 AM PAGE 1OF1 Alt. Parcel 04.28.19.61 L 040 - TOWN OF TROY 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 - GUNDERSON, TIMOTHY A & MARILYN TIMOTHY A & MARILYN GUNDERSON 519 FRANCES AVE HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 519 FRANCES AVE SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 2.800 Plat: N/A-NOT AVAILABLE SEC 4 T28N R1 9W 2.80 AC E 1/2 SE 1/4 LOT Block/Condo Bldg: 1 OF CSM 5/1335 ALSO COM E1/4 COR SEC 4 S 1 DEG E 1046.22'- POB N 89 DEG W Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 83.70'S 1 DEG E 315' TH S 89 DEG E 04-28N-19W 83.70' TH N 1 DEG W 315' TO FOB Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 746/333 07/23/1997 698/110 2006 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/15/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.800 58,000 204,900 262,900 NO Totals for 2006: General Property 2.800 58,000 204,900 262,900 Woodland 0.000 0 0 Totals for 2005: General Property 2.800 58,000 204,900 262,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 105 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 ✓ S ~ TOWNSHIP SEC . T ~N-R (Cj ADDRESS ST. CROIX COUNTY, WISCONSIN SUBDIVISION S . LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H 63 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 1L~. IMF C ~ IDG? 1~~~ Sc-c.. j~ ~ ~ j c'+ ~~►1Ks~o.j lYcrllCv. 3C~ JAY P M r i to ~ e 3 a / r F INDICATE NORTH ARROW "rct~ l e-7' BENCHMARK: Describe the vertical reference point used Se, E ayrre~ Elevation of vertical reference point: r AL Proposed slope at site: SEPTIC TANK: Manufacturer: G{~' S K _K' Liquid Capacity: /'O 0 & 9 a- Number of rings used:- Tank manhole cover elevation: 167B,,00' Tank Inlet Elevation:/ 5 ,-Z Tank Outlet Elevation: / ? Number of feet from nearest Road: Front,~/J\ Side10 Rear, O feet From nearest property line Front, 0Side,QRear, 0 Z/ feet Number of feet from: well building: -2/~~,~~ds~a~ (Include this information of the above plot plan) ( 2 ref.er_pn~ 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, CSide, 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:_ 0 Number of Lines: Area Built: 90 5+~ T Fill depth to top of pipe: % `d r Z~' Number of feet from nearest property line: Front, O Side, Rear, O Ft. Number of feet from well: f~ Number of feet from building: l (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: 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 7-3707 BUREAU OF PLUMBING F~CONVENTIONAL ❑ALTERNATIVE Slate Plan I.D.Number ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound ITfassigned) 4 NAME OF PERMIT HOLDER: A 57 DDRESS PERMIT HOLDER: INSPECTION DATE. Tim Gundeuon R. 3, Box 70, Hudson, W1 54016 BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN / NF SE, Section 4, T2 8N-R 1961, Town 0~ Tno y Lot # 1 REF: PT ELEV. CST REF PT ELE Name of Plumber. MP;MPRSW Nr~ C.unry. Sanitary Permit Number: Dougtals S;f.ohbeen 5432 St. cuix 58885 SEPTIC TANK/HOLDING TANK: MANUFACTURER. _ LIQUI CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER PROVIDED PROVIDED A< YES ❑NO ❑YES ❑NO BEDDING: VENT DA.f: l VENT MAT L. HIGH WATER ALARM NUMB ROF ROAD: PROPERTY WELL. BUILDING: VENT TO FRESH FEET FROM LINE IAIR_INLET YES ❑NO ❑YES ❑NO NEAREST DO ING CHAMBER: MANUFACTURER BEDDING. LIQUID CAPACITY JPUMP MODEL PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER ❑YES ❑NO PROVIDED PROVIDED GALLONS PER CYCLE: PUMP ANDCONrnoLSOPERATIONAL ❑YES FIND ❑YES ❑NO NUMBE EET FROM OF PROPERTY WELL 6uILEING I VENT T FRESH (DIFFERENCE BETWEEN F FEET FROM LINE AIR INNLLETE. PUMP ON AND OFF) ❑YES ❑NO NEAREST SOIL ABSORPTION SYSTEM. Check thesoil moistureat the depth of plowing LENGTH 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: W IDTH LENGTH NO. OF DISTR. PIPE SPACING. COVER INSIDE DIA -PITS LIQUID BED/TRENCH If TRENC DIMENSIONS / "Ar f PIT DEPTH c2 %J s GRAVEL DEPTH FILL DEPTH UISTR. PIPE DISTR. PIPE DISTR///ttt~~~IPE Mggq,,, TEp IAL. PNIO. DISTR. NUMBER OF BELOW PIP ABOVE CODER ELEV. IN Er ELEV. END I / /l PROPERTY WELL'. BUILDING. VENT TO FRESH /f/ I),/ ~~~I PES4^ FEET FROM LINE. AIR INLET. NEAREST--s 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 MARKERS OBSERVATION WELLS ❑YES ❑NO ❑YES ❑NO DEPTH OVER I --H : BEU DEPTH OVER TRENCH BED CENTER DEPTH OF TOPSOIL SODDED SEEDED JMULCHED. EDGES ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH LENGTH TRENCHES WO~OF LATERAL SPACING GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER : DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL. NO. DIS=DSTR ISTRIBUTION PIPE MATERIAL & MARKING ELEVATION AND ELEV ELEV DIA ELEV PIPES DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MAT ENIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS ❑YES ❑NO ❑YES ❑NO COMMENTS: PERMANENTMA RKERS: ]OBSERVATION WELLS N : PROPERTY WELL: 7DING. FEET FR UMBER OF LINE ❑YES ❑NO ❑YES ❑NO NEARESTM Sketch System on Retain in county file for audit. Reverse Side. % S GG fyAT RE TITLE/ DILHR SBD 6710 (R. 01/82) 4YG j yY /f / A~ wl5mns,n APPLICATION FOR SANITARY PERMIT 1r DI,LHR COUNTY (PLB 67) UNIFORM SANITARY PERMIT # 1 0U5TRV, LRBOR & HUTRn 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 AD RESS "v, l© a PROPERTY LOCATION 1 /4 5 it1 /4, S , TZ$; N, R E (o W TO 6 Q~ LOT DUMBER BLOCK NUMBER SUBDIVISION NAME NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER TYPE OF BUILDING OR USE SERVED X 1 or 2 Family Number of Bedrooms. Public (Specify): THIS PERMIT IS FOR A: I< 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 X 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 0040 1 a~ x 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 414 Lift Pump/Siphon Chamber Manufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): 1QN 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): Signature: MP/MPRSW No.: Phone Number: Plumber's Address: Name of Designer: COUNTY/ DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: ❑ Disapproved IV f El 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 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/contractAr,("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 ,r ;cam Location of Property', Section T N - R~ Township Mailing Address Subdivision Name Lot Number / "r7 A Previous Owner of Property 3No~~ Total Size of Parcel ~C Q 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 and Page Number as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Warm y 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. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERI Y OWNER CER7 i F ICATi ON I (We) ee4ti6y that a.U Statement6 on -thii6 6onm alte thue to the best o6 my (oun) knowledge; that 1 (we) am (cute) the owneA(s) o6 the pnopenty de~seiuubed in thus inboamation Jonm, by viAtue o6 a wahttanty deed necoa.ded in the 066ice o6 the County Regiz te,, o 6 Deeds as Document No. j and that I (we) pnesentty own the pnoposed site 6oA the sewage, dizposat system (oa I (we) have obtained a.n;easement, to nun with the above descAibed phopenty, bon the const)Lueti.on o4 .6aid s y,5 tem, and the same has been duty necotcded in the 066ice o6 the Coup;.,; y Regi.6 ten. o~ Deeds, as Document No. / SIGNATURE ( OWNER SIGNATURE 7 CO-OWNER (IF APPLICABLE) ~Z_ -3 - ~ & - z-3 DATE SIGNED DATE SIGNED ~ H G r-] y r S T C - 105 r y SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County z d OWNER /BUYERS iM G~~1.~C 5,~~~1 rn ROUTE/BOX NUMBER Fire Number ZIP y~_ ! CITY/ STATEf4~:;~,., lc 5, j" VC PROPERTY LOCATION:, E, 14, Section, T 2-V N, R /9 W, Town of 40 ySt. Croix County, Subdivision I 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 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 ti three year expiration. w o I/WE, the undersigned, have read the above requirements and agree cn to maintain the private sewage disposal system in accordance with H the standards set forth, herein, as set by the Wisconsin Depart- o 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,_4et~ D AT E 1~~_ 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. Edina R Hudson Office Ac' 700 Second St., Hudson, Wisconsin 54016 • (715) 386-8236/Twin Cities 436-7072 y P 1 ~1 C.. DES C WESTERN WISCONSIN ! LOTS AND ACREAGE Price 6~j Add 1 Francis Avenue ap Hudson Code Dist.0~ XStreets off Tower Rd Township T~ Acres 2,19 Lot Size 2 ear R Side Front L Side Lake Frontl o Topog Zonin 9 aFr/re- Restrictions - [ )Gas [ pvd St,. [ }JEasements [ )C/Bus [ _mt [ -Cat f Trees [ )septic [ [ jS waG' [ "Wells N!oy [ ]Streams [ j 1 [ )Fence [ )Str!Stakes [}I&gn [Abstract _ [ jf oRe s [ erc. test [ )Storms Taxes Assess PresentTinanang _ payments Legal Desc 8 Remarks located in the NE a-, of the SE , and the SE of the SE 3-, of Sec 4 T281" R19W-Lot 1 located on Francis Ave. Owner offerinrL/C,sub- _rnit terms xi r Knoll overlooking entire area suitable for each bermed hone SB Comm PRAR eV-0 hnson /p. Ste ffe Ph. 4 -61 0 Brkr. Frei na Realty, h-~86 Poss. Date clos, -82 6 , i Realty REALTORS m, MLS ~ n x x m O (D 7C (7 (D O_ a o a3 w w w,~ w to C .1+ f0 cr 0 C B O 7C K 0 1° ° C (p U~ (D a (h 0 :E a a o :E o m ° av~ w o cD ~ ~ moo m~mww~ M :L co fl 3 a c ,0~ w owo-,~ to > > go 0 0 Cc- r3- gm l co) cc~Qmf0 1 w ,y N ~m w w Co. z a~ m ("o° am ° ° CD 0 < M N N ~c0 Q O A (D ' o D .O. O CD ~c (O Ci =r 0 (~D CCD'- O C p1 a w *O N? w N~ n+ 7 c~ Z 1 ~I ID (D -4 (D a+ n ? ? W C 06 N cn CD A 3 N O N a D CD C W O? n m -•C a ~~?c w O * -.o m 7 w Qy = CD 0 m- 0. 'M v;wa ac C., C IT1 CD 0, 0 - ate w ((D 0 -4 v► o c "cam O in °3M cQocf ao:E Nccawo. R1 w m w (D - (D (n 7 ao m as acv; P M Qo w r.o _ x.00 on :3 w~o ao o(o c M -Im c o i'i CL cow sw -0 C C d. O (D = 0 0 M 3 O ~3 n m 3 ° < w N a o Ca 8 _ y o ~O IDUAR. Y NT OF REPORT ON SOIL BORINGS A SAFETY & BUILDINGS DIVISION 1,0, BOX 796 LABOR *ND PERCOLATION TESTS (11 DIS ON WI 53707 HUMAN RELATIONS (H63.09(1) & Chapter 145.045) ~/G CF t, LOCATION: SECTION: ~TOWNSHIP/MUiWCtPA-L-t LOT ..BLK.Nw° ME: 1/ 1/ y /T-,"- N/R E (ors COUNTY OWNER'S/BY"€FC'S NAME: MAILING ADDRESS: USE DATE VQTI NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFIL CgPf . PERCOLATION TESTS: 'Residence ❑ New ❑ Replace - RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: ISYSTEM-1 N-FI LLHOLDINGTAN K: RECOMMENDEDSYSTEM (optional) QS ❑U ❑S ❑U ❑S ❑U ❑S 0 ❑S ❑U If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the v.' under s.H63.09(5)(b), indicate: ~ , Floodplain, indicate Floodplain elevation: ~ PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCITES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH I ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) z C • \D~•3 ' 3 'Zan v'rZ b' huh i2va% ST 36' ~3' ~nSj/,V3.1` l"-Pn o l B- LL - 'a b b•~" \177.Q' !i %~,yr O•s' ~•3~)jh(;t-~$jJ~•~ B B---._ B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER -144G49S AFTERSWELLING INTERVAL-MIN. PERIODt PERIOD2 PERIOD3 PERINCH 71 1 S; 7 P- 7 P_:~ JU 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 LiiraE s o 3 3 Al -V boo A A ~ v: A6 _~153•.~t~ t _ - _ eon b~.~ 6 ~ _ ~ ~ ~ N _Z45~•~L(~al~ _ - - - (~D 3.3 eJ.Ik --I E I I E ; Z t S' c~ S t 72 E IASXS 4~ - 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: ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): CST SIGNATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) OVER - Mr T` ,_;'URA -a=ria?., & 1 , odor, f ?:o 3 is mA rhis a new or . E r" tF >rF' E,n; '-j,.~ [ ty wing ° ~ of M HE RULED ~ OUT 'S001- I~F3 ~.e~-;r.~ EASE ; . ` KE UP A L I wW., v a m,,V km do l l,.o scai Pta,[U, €cd, A r. . °sr r , o,' ' ' .s if r,c's.ind, e, ..t;£ Volvo! ~ O .U.:", wwom i..3::at yet ; c(., w,, - r _ , . wt, t sXvb as 10 Lt's" 1 nod ilk: n f , 4 wi€: a ~t..F in Mod ti,xt" W e :r°i , riv'PS no! 9 t ?tr'- j me iC i m'z3 as i a your amr, . taid n.y ,om (1 E:l S I .FI=='. i; Wow an E,',`. 'fit 901!{ { ,.~x _ ) ~~C, Now t3. W BW si ,me W, s E , QwW, ,r Coo w M! 10C F"Am Imp ,ry=~0l 2C~ p<m, Lwow 't r'_' pis d' Coy 1 WQ Coy Law R 'ilt mot r WOW j Ff V; Oro 'o TT) c c, c c, P n kS r; w * m -t 0 N :r ro rn . fns -1 N 0 Oo V,, P vt N (A 0 - E F a '~kb I_A P . an -i ~P N oG . ~ y © C1 F e 'tb T' I 1 ~ Q et r. P Nc. '00, 7t7 6 - ~ _y, 1'~ A r IZ LA 03 # p , h1 46 p s 04 R P c e ~ 'C a, ''b tic I ! P R n P u ! r N,* lit, 't > N ! v ' -cj co F I } I it I ~110 I ~ c u~ P o z c w P P N O A .M. T ~ ` X31 ;a - to ►nc o~ F u, e'