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HomeMy WebLinkAbout040-1034-95-003 n N O m •O n d r~ i 0 m f c °1 ° CD _a A o v 3 # O c n 3 F poj M o Z ° A °rn °a. m O o m ° z 3 S' m m CO d. N cOi N Cn (p " (c L~ O '1 N _ 7 O o m o O C A < O N rn _ 7 f/1 ~ w v c_n C D w o n :3 (A CL CD :3 O A T~J H c Q o r O o a c N 3 O rn T CD - G~ O OD 2 ~i TJ G~ z ° ° c _ A 00 N' fA O c Cz) z Z 0 ° ci ai ai o w D v y w M. o ;T N m fn cn H O ( - i (c (V z CD w N) _ c N z ° Z co /'Z o ON D CD 0 O c4 v a, ° m 3 . i tv G 44. O N O 7C1 rn z ~ v Z c Gi v In _ ~ ~ C1 O O r- z -1 00 O C) W * " s CL , z 00 0 3 a w o " z co N z w O CL (D Q- 0 M ° - ' d :3 C (D z O d O O a N (D A b m I ~ t o I ti 0 0 A O b A N N dQ N fA 0 ti H O 0 (D ti 'Parcel 040-1034-95-003 12/09/2005 11:17 AM PAGE 1 OF 1 Alt. Parcel 8.28.19.112G 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 - WESELI, MICHAEL J & JENNIFER A MICHAEL J & JENNIFER A WESELI 460 COULEE TRAIL HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 460 CTY RD FF SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 2.897 Plat: N/A-NOT AVAILABLE SEC 8 T28N R1 9W NW NE 2.897 AC LOT 3 OF Block/Condo Bldg: CSM 5/1385 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 08-28N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 960/578 07/23/1997 796/332 07/23/1997 699/173 2005 SUMMARY Bill Fair Market Value: Assessed with: 102263 202,300 Valuations: Last Changed: 07/19/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.897 58,500 136,200 194,700 NO Totals for 2005: General Property 2.897 58,500 136,200 194,700 Woodland 0.000 0 0 Totals for 2004: General Property 2.897 58,500 136,200 194,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 124 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 VIfA TOWNSHIP ThO SEC. T N-RI W ADDRESS ST. CROIX COUNTY, WISCONSIN i i SUBDIVISION LOT LOT SIZE y / 3a S PLAN VIEW i Distances and dimensions to meet requirements of FI 63 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ~vo,2dL~ Go T G Va7• 135 N6 Hof A 1A t ~ o ,y . /0 60, y ' 2Co•S IC w~l~ INDICATE NORTH ARROW W BENCHMARK: Describe the vertical reference point used N(c, zoT~i~o~ P Elevation of vertical reference point: /0D ' 0 Proposed slope at site: 3 SEPTIC TANK: Manufacturer: Liquid Capacity: /azo fd_1 T Number of rings used: ~'716~-~ Tank manhole cover elevation: 7z / Tank Inlet Elevation:! Tank Outlet Elevation: i Number of feet from nearest Road: Front, @Side,O Rear, O > Z D Q feet From nearest property line Front,O Side,O Rear, O ~S feet Number of feet from: well 66 building: ~p `s (Include this information of the above plot plan)( 2 re{Pr",~> ~'T i PUMP CHAMBER ~ Manufacturer: Liquid Capacity: _ Pump Model: ~S~iphon Li Manufac r: Pump Size Elevation of inlet: ottom tank elevation: Pump off switch elevati Gallons per cycle: Alarm Manufact r: Alarm Switch Type: Number feet from nearest property line: Front, 0 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: /3 -1~ Width: Length: 3 ~ Number of Lines: 3 Area Built: Fill depth to top of pipe: 4*K4~(141WIIeL Z Number of feet from nearest property line: Front, O Side, Rear, O Ft f / Fi. Number of feet from well: to Number of feet from building: (Include distances on plot plan). SEEPAGE PIT Size: Num its: Diameter: _ Liquid depth: Bottom of seepage p' levation: 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 Manufa Capacity : Number of rings used: Ele ion of o f tank: Elevation of inlet: Number of fe rom 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: HOMESITE SEPTIC PLUMBING CO. Inspector: RT. 3 O'NEIL RD.: HUDSON: WIS. 54016 ROBERT UtBRI WIS. MASTER PLUMBER LIC. NO. 3307 M.P.R.& Dated: Plumber on _job: MINN. INSTALLER & UESIQNFR LIC NO 00663 License Number: 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS ,LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O.. BOX 7949 BUREAU OF PLUMBING MADISON, WI 53707 CONVENTIONAL ❑ALTERNATIVE State Pl-1,D. N-be, llt assigned) ❑ Holding Tank ❑ In-GLund Pressure,,`_ ❑ Mound NAM F RMI OLDE ADDRESS OF PERMIT HOLDE INSPECTION DATE: Evan Vie,c,e e RR#2 Red Pane Tnait, Hu6on, W1 -,-141193il3000 BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.. CST REF. PT. ELEV. NW NE Section 8, T2 8N-R 19G1, Lot# 3, Town o j Tu y Name of Plumber. IMPIMPRSW N,, County. Sanitary Permit Number_ Robext U.2bAicht 3307 St. cuix 54905 SEPTIC TANK/HOLDING TANK: MANUFACTURER 1 LIQUID CAPACILT.YI TANK INLET ELEV.. TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER _ P IDED: PROVIDED. I } YES ONO DYES ONO BEDDING. VENT DIA.. VENT MA i HIGH WATER d NUMBER OF ROAD: JPROPER-F T~.L, BUILDINGVENT TO FRESH ALARM 7 FEET FROM LIN~ AIR INLETDYES ONO tl ❑N0 NEAREST~~ DOSING CHAMBER: r` MANUFACTURER BEDDING. LIQUID CAPACITY PUMP MODEL PUMN MANUFACTU H WARNING LABEL LOCKING COVER PROVIDED: PROVIDED. DYES NO DYES ONO DYES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. J NU PROPERTY WELL BUILDING IVENTTO FRESH (DIFFERENCE BETWEEN _ NU T Ts OM LINE AIR INLET PUMP ON AND OFF) DYES ❑ 46 NtAR T 30 SOIL ABSORPTION SYSTEM. Check the soil moistureat thedepth of plowing JLINI,11 DIAMETER MATERIAL AND MAHKING or excavation. (If soil can be rolled into a wire, construction shall cease until F CE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: WIDT14. JLENjGT NO. OF IDISTR. PIPE SPACING COV _ JINSIDE DIA #11TS ILLIQUID BED/TRENCH TRENCHES N T RI DIMENSIONS f 01 / )0 I PET DEPTH GRAVEL DFPTH FILL DEPTH OISTR PIPE DISTR. PIPE DISTR, PIPE MATERIAL No. DI H NUMBER OF PROPERTY WELL. BUILDING. VENT ''TO FRESH BFLOW PIPES ABO COVER ELEV. IN-11 ELEV ND _ PIPES LI AIR/NLET= ( FEET FROM'C~ 11r NEAREST-1- MOUND SYSTEM: Mound site plowed perpendicular to slope Ck the texture othe fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mo lid systems to ake certain that it ON REVERSE SIDE. SHOW ELEVA- D YES O meets the criteria fo medium sand. TIONS MEASURED. NO SOIL COVER TEXTURE ! : / ` PERMANENT MARKERS JOBSERVATION WELLS I 'I DYES ONO DYES ONO DEPTH OVER TRENCH.'BED DEPTH OVFR TRENCH; BED IDEPTH OF TOPSOIL SODDED SEEDED MULCHED CENTER EDGES DYES ONO DYES NO DYES ONO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH LENGTH. NO.OF LATERAL SPACING. GRAVEL DEPTH BELO r PIPE FILL DEPTH ABOVE COVER. BED/TRENCH TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MNO. DIS R DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING. ELEVATION AND ELEV.. ELEV.. DIA. ELEV.' - A" PIPES. DIA.: DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY J,]COVER MATE AL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS DYES Q O ' C / DYES ONO COMMENTS: PERMANENT MARKERS: rSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: FEET FROM LINE. OYES ONO OYES ❑O NEAREST CIL 1 Sketch System on Ret county file for audit. Reverse Side. SIGNATURE,:. TITLE. ~r DILHR SBD 6710 (R. 01/82) _ wisconsin APPLICATION FOR SANITARY PERMIT .,Z~i.D[LHR (PLB 67) COUNTY t~ oE~RRTmEnTOF UNIFORM SANITARY PERMIT # - InOUSTRY,LRBOR5HumAn RELRTIons -Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 81/2x 11 inches in size. -See reverse side for instructions for completing this application. PLEASE PRINT PROPERTY OWNER ~EiPb M;4 LINLADDRESS PROPERTY LOCATION ~J- ,4101 /4 fViY1/4, S , 129, N, R 9 E (or & TOE OF: 0/l/ LOT NUMBER BLOCK NUMBER SUBDIVISION NAME NEA EST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER ,3 CSI'-t ~1d S U / S wig TYPE OF BUILDING OR USE SERVED A 1 or 2 Family Number of Bedrooms. ~3 ❑ Public (Specify): THIS PERMIT IS FOR A: Ic 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 Lift Pump Tank/Siphon Chamber Holding Tank capacity Manufacturer: tu _f 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 Lift Pump/Siphon Chamber Manufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): J3 1~ X3 X1 Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumbe SEPTIC PLUMBING CO. Signatu 1_5t4 MPRSW No.: Phone Number: D RL 3 O'NEIL RD., HUDSON, WIS. 54016 ,3 .3 d 7 (-7 15) MK- Plumber's mSrMTER PLUMBER LIC. NO. 3307 MARS. Name of Designer: MINN. INSTALLER & DESIGNER COUNTY/ DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: Disapproved 1/ / ~ _ ❑ Owner Given Initial ~j !O (O Z ` 4 _T 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. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Owner of Property ~U~~ Location of Property A/ /V~ ~4, Section T, T ZP N - R W Township Mailing Address P]-' Z ~Llr.~ 7/~~--f' Subdivision Name 310gs- P, Lot Number 44, 4t /Zd~J Previous Owner of Property y Total Size of Parcel / Jr 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 1 3O J as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Warranty Deed A) o7- ~ECC3/pPs;-P 7--6 )'AE - oT ltz" Mo,27"~~ ~ 3 o tv,~-~- C_7 . fJ~ ~ 2. Land Contract rS- It'd' 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 1 (We) eent-i6y that aU statement6 on this bonm ane .cue to the best o6 my (oia) knowledge; that I (we) am (are) the owner (.s) o6 the pnopenty desnibed in this .inboAmation 6onm, by viAtue o6 a wa Aanty, deed neco/.ded in the O~6ice o6 the County Regi6teA o6 Deeds " Document No. ; and that I (we) pne,sentty own the proposed site ion the sewage-ayztem (on I (we) have obtained an easement, to nun with the above deg cAibed pnopelcty, 6oA the con,sthuction o6 said 4y~stem, and the Game has been duty recorded in the 066ice o6 the County Re (~zt ,'6 Deeds, as Document No. ~ J. SIGNATURE OF OWNER SIG AT OF CO-OWNER (IF APPLIC E) - - J - 11~? - 3 - DATE SIGNED DATE SIGNED 4 "Awi. 5.t lu ?n 1 CEMPIED SURVEY MAP VIRGIL CERNOHOUS 1,r,r't, of the Northwoot 1/4 of the Northeast 1/4 of Section 8, TownsUp 28 Northo Range 19 Wort, '1`rwn of Troy, St, Croix Cotmty, Wisconsin. UN/LATTtp LANG! 4f1,AA 40,36.1 AooO' N ; A 1► 001 Of Q .N.. N N W _ p (j o ~ r " O p O N 0 as QQ Q C o N Nl N 3t O O '00 O O 8 •0 p n !00.00'00"t / 11 It 40.01' / r w fit N N _ ~ I • h 3u p ~ ~ l r 'f _J N 33S ~ A . g S 00.00'00 W z ~ ~ I HI 1!!3'.03' ~ oy S00.00'00"E. -Q y O O 00, T 1, 34' 0 °•O fa N 00'00'00"1q 00 w a. a ! IJ WI h 00" Noo•oo~oo"t tal,ir 41A ?i,•is~ ~T,g~ i I~1 d w N aq. 00 0,0 r; in o a ~ ~ ° a pi• amt'`, ~A% ® ~ g ~ k O W W I... < 3 W z w s Z z O Wd " © . o o r _ I W ,n V IR > N w o" { I C Z H ¢ y h O h j. / N AI W M / d~ sm is Nl U,~Na yl $ wa zs I goo* 00' 00" E M w i / a a N „ 117.61 Olei •za01D r/ 08~ _a / z Cr i ) W ado 1322.31' 1 alsaal6' 144.31' !!4l,47' WS 1/4 LINE Z ALL !lARINO$ REP. TO TNt N/! 1/4 LINt OF •1C.4, ei O © T29N,R19W,ASSUMED NOO•O9'S2"E M W K ~ ~ I ~ pM / . Q ,~tN~~~leeu N J N ~ ~ p low ONS 00 _ N•• O ~0 N " m % W ~O M Mf h' ^ ~ L ti W W MUR MY " •r. N % Q 0# S ~g zow W, wl C. O ~AGULL- 0 64.44' F. W. NOO.O$'32"E 22A.86' R 1 NORTH) REGISTER I I '°--LANOS (DESCRIPTION ON REVERSE) OTIgIED SUR L . cROIx COUNTY, w'2IscatvsIrr SHEET ! OF 2 H y S T C - 105 r y H SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County z d OWNER -R ROUTE./BOX NUMBER T L 7CA- P4 -Fire Number_ CITY/STATE ZIP- - /v ed PROPERTY LOCATION: `-4, ~4, Section T_LP N, R-T__W, Town of -;r-lo ~ St. Croixc County, Subdivision ~'s~ 3fdys~, Lot numbe ~/o/S /~•i31S 1 Improper use dnd maintenance of your septic- system could result in 1 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 tankui~_L)er. 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 m be eligib e to receive a grant Cor 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 a_1_I_ newsystems 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 F I/WE, the undersigned, have read the above requirements and agree U) to maintain the private sewage disposal system in accordance with x 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 wit in 30 days of the three year expiration date. SIGNED DATE I 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. -t /+DpeAw l GvOipK Tb O'V*IAZf•/ 'P&70'Oei 13y L. A10R/V4y C•S•T 211115 of /o - 2 o -19,P? • DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, c DIVISION P.O. BOX 76 LABOR ANO PERCOLATION TESTS (115) MADISO N WI 53707 HU-MIAN RELATIONS (H63.0911) & Chapter 145.045) LOCATION: E SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.: BLK. NO.: SUBDIVISION NAME: Nw 1/4 1/4 /TLS N/R 19 E co l V TiPo 3 S M. 3Soys vo% s 5 COUNTY: OWNER'S/B'C"Y`.E NAME: MAILING ADDRESS: S~ G-o~ X vgcl U~~ ,P T• iP~v 7.f'~4iL 11up..f0-J w/S Syo~ USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCOLATION TESTS: v tl New ❑Replace Q_ ~ 13 pC v I Residence 3 / 4- RATING: S= Site suitable for system U= Site unsuitable for system "y CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) NS ❑u QS ❑u ©S ❑u ❑ S ou ❑ S au e-mv• PrWO U IR '06 ' 630 s0. 7-If Percolation Tests are NOT required DESIGN RATE: .2,6 f! f I • I If any portion of the tested area is in the under s.H63.09(5)(b), indicate: M • Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS 0'ST~ z yyS BORING TOTAL DEPTH TO GROUNDWATER-IN; fl` CHARACTER OF SOI WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OB ERVIED (SEE ABBRV. ON BACK.) B-3 q- 2- ?ta;-c > P3 ' XkAOR 7- A- 7_74 a,_a,0 B-' g q ' /4 OT 210~ > f ~ B- : vu,e r mev zws Of= 147c5-17 PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER IN AFTER SWELLING INTERVAL-MIN. PERIOD L PERIOD 2 PERIOD 3 PER INCH P- i 3.9 9 2 Tu 1 u,: v P_ cs 4A aoQ 66 TF Dec' i vEO P_ ! S 3! 2 L - ,v F 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. ~c J- SYSTEM ELEVATION 770 "-1 3 No, /or GIwE- (z S X per' ' i"!3 3 /VE to r ro)Nclc ~ V 14,ee f /3/ 13,3 13 y x = E,e c S%r- JUX7 e_ 13 77 RO,J 3 5P 370 so /3 /3s ' r 4)'0 lif Vyr /,1 3,0 s y s TeIA - TFST" 4,Pe,+ . _ /3 , 13~- , E y _.a. 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): 110MESI! E TESloIN CO. TE TS WERE COMPLETED ON: ~r,h, APPROVED SITE VALUATIONS PERC TESTS) /3 " ADDR MINNESOTA LICENSE NO. 00663 TI FICATIONNUMBER: IPHONE NUMBE nal): -5-02482 5's-0 y(/y2- P/~ WR30Q'NMRD.,, HiTDSONII,W 5016 CST SIGNATUqE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - i Ij _d < Fltf and (Y_ .rr ,tt :(jal clescfiptpl r ws`a z tY E1 [Y1 F.d:"p E`E r:~ . ..'aXa.~HUNI number of hojw~,~M,,, u, tml/:e .'7a suiL €,71144 `I,ABLE 1 0R, , 'l0 1,. a C ' Y AF _ .w,. - 10 N S; I[i:€i a J"If' F 1 S R R (J C :Si,I [ £s _ # €_..#i ° F 1AS,i: w re f o, _ t '§F S; 1; sa 6. t;e, ~1I i, , con "I EiseG~i~ty the, . {at pi2 ~%KE A i G-0 a 4Jlr7 arm ac_+.a lacat lrl vo)t r "'t o { 1, 4 f1 ai.i hu .'i (?ark and V.. a! kfl-0Vaf:lolr< at, f~'~c it Y,t. P- ,lz. =il[, clz (,,oanp){pic ad s`!poiopiiai:(boxes Es<< 1.C) E:d:l [T ,l7 3El(E. ,,,f Y., k (~uYch as .Cry, o "iY < ,art r E 6)z-3 not i4,,rl7 })i,#t: .i.p Lltry: `'o, w at ql r -a,,c Your EFE~t ra i;r.l,ta, d3 L r ' •°'n L't,.E Er> bt ?roc i o .,,(•p~,r cp ~S~aY D t) )Iz (;3 1 std l?'-..(dt [ } Ls~`~ EJ L3 st r, rid.`; ~ , San 6 . ~ - P .:air;°= n~ : grt:Si~1€ ~Y,,:9 Fine S~,-~d gg €,,.E'r "FfS ,.~I dy.E Ian -t= LV ate c ¢ .z„ g e a ,.on of Y(3:a Sod te"T . in~ Ht,, TrY t [ Ot t°z r" S'r >`c Y roc E~ "tz ~ s - ~ `r: ' to f*01" MENT OF REPORT ON SOIL BORINGS AND SAFETY 8a BUILDINGS INPVST.RY, DIVISION I I P-0. BOX 7969 i,ABOR AND• PERCOLATION TESTS (115) MADISON WI 370 HUMAN RELATIONS (1463.090) a Chapter 146.046) '"W Ta73.- SU TOM ~ijWhpi15j()rJ NJCfJ[ ` '/4 IT, 0 N1 (U COUNTY: 11Jw S NAMI : itTWAL Csi AFB DATttS OBSERVATIONS MADE IPEFiC?fI7CT1aN'f'~fi Racldoriro I 1 . New EiHaploce -Ij ~r~ 11 Y.. - NZS:~Mg 0- CT X1~llpflbN _ ~t~~FT[DE~CFfT>~71bT~B H RATING; 8- Site suitable for ay 1!1r U. Site unsuitable for system _ _ _ i- J CONV' NYInN1ll . M6.0t4tS: C'a If I G(,bl1NbP 1E"S[ ~TE1JI (f1 TL OC[)INGNK: HE~MM NDED Z3YSTEM.Iup,iui+~l) k ,v~ - l~ (vuletu~Ii TMstr or* NOT ryqulred~~ CJ~§1ZiN HA'I'~; It nn f v p4nlun of the tasted area is In Iha lujagr s,NB i 09(6)(ti), indicate:.4 Floodplrln, Indicate Floodpluln elevation; PROFILE DESCRIPTIONS BORING -TCYIAL r h- A ~i-I CTT A A H H N SS. COLOR, TE TUR D DEPTH N•.UMw1IER l)tl'1 IN, I~LEVATI,ON T 9 DH K I O S E AB6RV, N CK.) 45 Ole f r^a 4 f 4rSe < ~ ~ ~ is l.'. / yp~ M PERCOLATION TESTS /GG U- p _ ..r... a PLOT PLAN, Maw 194dons At' W901011Rt,1 "All, 0411 borlnaf 'Nnd t( iolnvnsionc 91 syltA01v soil Grew. IndloptG rgh10 pr distar psis. pesci wo whet are the hors. xontrl anti vertl* a,iavotion r~teiana painU and Thaw their Igcatign of th'M 0(9t PI4n.. Now tfUl stlA00o Glavtltlon fad all bgrinyt and the dlraation end perpant of land elo~. 7 * r 1 .++Q r..e^~ ~"1M!:M ^4` AM 'k! SYSTEM KLE AVON a 2W 1 j .,M1'i,~.~. .sir-~. 4•l' rM1 i T tI~ -7 7-7 24 i~ +l',rl Yt I + +r `1 ( 1 N . wt... . i,' - . .1.. wn. . , f... I I , .17 I, the undersipng4, hereby o*rtily that the oil teats rf+t o(W on this fort" were *dq ay nip In accord with that prarxdutes end rng> ?oqs specified In too Wisconsin Administrative Goth,. and ~1hpt the delta raao #md and t(te IopNtlon of thM i"tf 11f# *0erpQA W tha best of r►IM" nowfidM dad b.ll vl; L Al'lEPilft awn ST SIGNATURE: 4 gltiT4111aUTiGll~a t~ngl r~. Gttd A4tAstrl t'rapprW' rll(I4 soil psi !ri r r oil NR 5BD BtKa?t i1 - t f ~ r `~t J' ~f `~l} i ` •ta ~ 1 K$;•r k~ ~ 1t 13P. 1 WWA* PLOT and O 5 S%TJON FIANS Ale r ~ h c o v ,v -/-C, '4j ece9c_c PT) ° r i I M -ro! FT- (0 -7 3&1 ~3 6'o X 2,5 1 31°6 v vT J`2GT` h~ `6 A15D E SEPTIC pc, p, a~l(7 SCI] w~~~ OWEII RD J~15tv~,, Ct1. /CE~tIS~ P rntpSQN ,S Y15c QBERi J!Gar,,,, ~'r: 5v""016 rV?i. IiUSTALtj &„"tic. f"j. J 0'7 p R C 00. Fresh Air Inlets And Observation Pipe .SoiL TE5*r1X%5 By HOMESITE ' ES-j' NG ~:G-. Approved Vent Cap RT.-3, cY`'ldt' i,6 its: °3 HUDSON, Wis. 111 4ps96 Minimum 12" Above Final Grade `r t-t,°,..i&-(~ ~ '4'6t E` qw. V "C 4°' Cast Iron Above Pipe 'o Final Grade ~ Vent Pipe Marsh Hay Or Synthetic Covering S! Min. 211 Aggregio PIA Over Pipe Uistributi - Tee i Pipe o a a U Aggregate Perforated Pipe Befow Beneath Pipe Coupling Terminating At Bottom of System f J